**Applicant must be at least 18 years of age and a U.S. Citizen or Resident Alien to be licensed. See Real Estate License Requirements for more details. Class attendees are required to pay a $100.00 non-refundable deposit with the balance due (complete payment) paid at least five (5) days prior to the class start date. If attendees do not attend the Prelicense class the full payment is non-refundable, however the amount may be applied to future Prelicense classes beginning within one year of receipt of the initial payment.
First Name: Middle Initial Last Name:
Mailing Address:
City: State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code:
Home Phone: () - Cellular Phone: () -
Work Phone: () - extension Fax: () -
Mail a Text Book to me at the above address: Yes No N/A . (Please note there is a minimum charge of $45.00). Text Books can be picked up in the Hawaii Kai Office to avoid the shipping and handling fee.
Email:
Preferred Method of Payment: Master Card Visa Money Order Check
Credit Card Number Expiration Date: January February March April May June July August September October November December 2008 2014 2009 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
If using a credit card enter the last set of three digits on the back of the card:
Class Starting Date: Month: January February March April May June July August September October November December Day: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year: 2008 2009 2010 2011 2012
Class Location Desired : TBD Big Island - Kailua-Kona Big Island - Hilo Kauai - Lihue Oahu - Waikiki Oahu - Hawaii Kai Oahu - Kailua Maui - Kahului
Please fill in the above form and print. Then fax form to: Fax (808) 263-2114
No Printer? Apply by phone Toll Free 1-800-523-7440