Please provide the following contact information

SECURE ONLINE REGISTRATION FORM - ED SMITH REAL ESTATE SCHOOL

Please provide the following contact information:

Fees

3 credits $ 45 6 credits $ 85 7.5 Credits $ 95 9 Credits $ 105
$205 Total Fee for 15 credits in one day

Paper certificate by US Mail $ 10 additional

Change class dates an extra fee of $ 10

Maryland Pre-license Real Estate Class $60 deposit

Social Security Number only required for Real Estate Pre-License Students

First Name

Last Name

Social Security

Email Address

Please review your email address. A complete email address required to complete registration

RE-TYPE EMAIL

Address

City

State/Province

Zip/Postal Code

Previous Student?

Class Date 1

Location 1

Number Hrs 1

Start Time 1

Class Date 2

Location 2

Number Hrs 2

Start Time 2

Day Phone

License type & Broker's Trade Name

Please provide the following ordering information:

BILLING

Credit Card

Cardholder Name

Card Number

Expiration Date mm/yy

First Name
Last Name
Social Security
Email Address	Please review your email address. A complete email address required to complete registration
RE-TYPE EMAIL
Address
City
State/Province
Zip/Postal Code
Previous Student?
*Class Date 1*
Location 1
Number Hrs 1
Start Time 1
Class Date 2
Location 2
Number Hrs 2
Start Time 2
Day Phone
License type & Broker's Trade Name

	BILLING
Credit Card
Cardholder Name
Card Number
Expiration Date	mm/yy