Real Estate Licensing Exam Location Request Form

Real Estate Licensing Exam Location Request Form
Please complete all fields below to request your preferred location for the Real Estate Licensing Exam. All information provided will be used solely for scheduling your exam.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
State of Licensure
Preferred Exam Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Preferred Exam Location (City or Region)
Alternate Exam Location (City or Region)
Reason for Location Request
Accessibility Accommodations Needed?
Additional Comments or Notes
Should be Empty: