Free Print File - Michigan

BCS/LAP-120 (01/09) Michigan Department of Energy, Labor & Economic Growth Bureau of Commercial Services Testing, Education & Program Services P.O. Box 30018 Lansing, MI 48909 517-241-9231 Telephone; 517-241-7539 Fax www.michigan.gov/bcstesting

This document can be completed on-line, printed and mailed to Testing, Education & Program Services. This form cannot be submitted electronically. If you need to clear the form for any reason, click the clear button.

REAL ESTATE APPRAISER CONTINUING EDUCATION & PRELICENSURE COURSE REPORT

AUTHORITY: P.A. 299 of 1980, as amended COMPLETION: Mandatory PENALTY: Failure to complete may result in education credit not being recorded

INSTRUCTIONS: Report attendance within 15 business days of the completion date for each course. Please type or print legibly and provide all required information requested. Incomplete or illegible forms will be returned for correction. Instructors wishing to receive continuing education credit for teaching a course must be listed under the Student Information section. Credit for teaching a course can be granted only once per licensing year. Note: Each course number & type (prelicensure or con-ed) must have its own course report submitted.

Course Information
Sponsor Number Sponsor Name Sponsor Telephone Number

Course Number

Prelicensure Con-Ed

Course Title

Course Beginning Date

Classroom Hours

Instructor Name

Contact Person Name

Course Ending Date

Course Location and Complete Address

Student Information - All information is required in order to receive education credit - Type or print legibly
Appraiser License Number License Type* Student Name Appraiser License Number License Type* Student Name

*License Type Key: L-Limited Appraiser; SL-State Licensed Appraiser; CR-Certified Residential Appraiser; CG-Certified General Appraiser
DELEG is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities.