Instructor Application

Print out this form and fax or mail to

Ed Smith School, LLC

PO Box 371

Ocean City, Maryland 21843-0371

All information will be held in strict confidence.

   Name:   ____________________________________________________________

   Home Address: ______________________________________________________

   City:  __________________________ State:  _____ Zip: ___________

    Day Phone:  _____________________   Email: __________________________

   Company/Agency: ___________________________________________________

    Designations you hold :  ______________________________________________   

   Currently active as instructor :  Yes____       No____        Teaching Experience:   #  _____ years

    Briefly describe teaching experience and education:    

_______________________________________________________________________                                         _______________________________________________________________________

_______________________________________________________________________                                         _______________________________________________________________________

    Currently active in real estate? ______     #  ______   years Licensed

    Type of Real Estate license Held: (circle)   Broker    Associate Broker     Salesperson

    Name states where you hold or have held a license _____________________________  

    Names / Titles of  Courses you have recently taught:  _______________________________________________________________________                                         _______________________________________________________________________

_______________________________________________________________________                                         _______________________________________________________________________

Equipment: circle each item you have 

  laptop      overhead projector      screen      LCD projector      copier to make transparencies

Best time of day  to Telephone you : _____________________