REAL ESTATE TRAINING INSTITUTE

Please print this form, complete it and mail with copies of relevant certificates of completion to Real Estate Training Institute, 1636 Popps Ferry Rd. Suite 108 Biloxi, MS 39532. Or, apply by fax to 228.354.8533

I, _________________________________________ [name], license # _______________________, do hereby request that I be awarded the designation of Real Estate Professional (REP).

Signature: ____________________________________________ Date: ______________________

Applicant Information

Street Address: _______________________________________________________

City/Zip: ____________________________________________________________

Phone: _____________________________ Fax: _____________________________

Course Details

I have completed the following RETI courses for a total of 90 contact hours:

Course: Salesperson Pre-Licensing            Date: ___________________

Course: Salesperson Post-Licensing           Date: ___________________

**Please include copies of certificates of completion.