LICENSE EXAMINATION APPLICATION Real Estate Agency
(FOR REAL ESTATE BROKER OR PROPERTY MANAGER LICENSE) 1177 Center Street NE
Rev 05/2005 Salem OR 97301-2505
Phone: 503-378-4170
INSTRUCTIONS: 1) Please carefully read the Examination Information in the “Real Estate License and Examination
Information” booklet or at www.rea.state.or.us before making your exam choices.
2) Applications that are illegible, incomplete or not accompanied by the $75 fee will cause a delay in
processing your application.
3) Please print clearly or type all information. Original signatures are required. Faxes are not
accepted.
SECTION A APPLICANT INFORMATION
Legal Last Name (please print) Legal First Name Legal Middle Name
Personal Mailing Address Phone Number
( )
City, State, Zip Alternate Phone Number
( )
County School Code (See back of Application) Permanent ID # (If known) Date of Birth
SECTION B EXAM SELECTION
EXAM TYPE. Check one.
Broker Exam*: both National & Oregon sections * The Broker exam is required for
(Both sections are required. See information book.) - new broker applicants, and
- already-licensed brokers upgrading
Broker Exam*: National section only (retake) to sole practitioner or principal
broker, who have not previously
Broker Exam*: Oregon section only (reciprocal, retake, or out of state) passed the broker exam.
Property Manager Exam
SECTION C ACKNOWLEDGEMENT & SIGNATURE
Read this section carefully before signing below.
I understand and acknowledge that:
upon approval of this completed application and fee, an Eligibility Letter will be mailed to me within approximately
two weeks. The Eligibility Letter directs me to contact PSI Examination Services to schedule an exam;
being eligible to take an exam does not mean that I have met all requirements for issuance of a license;
if I fail the exam for which I am applying, I will not be able to review my test questions; and
if I fail to appear for the exam appointment for which I am scheduled, I forfeit the exam fee.
Original Signature of Applicant (Read statement above before signing) Date
SECTION D PAYMENT
Exam Fee: $75. Payment may be made by check or money order payable to the Real Estate Agency or by credit card (VISA or MasterCard). Do
not send cash. Complete this section to pay by credit card.
Card No.
VISA MasterCard __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __
Billing Address Expiration Date (mo/yr)
__ __ / __ __
Authorized Signature
EXAM APPLICATION $75 - 0423
School Name School Code ERA Nicholson & Associates Prudential Northwest Properties
A+ Real Estate School ....................................... 0522 Real Estate School ............................................0049 Institute of Training - Portland............................0077
ABC School of Real Estate ................................ 0033 ERA Nickles & Co Realtors ..................................0484 Prudential Northwest Properties
Abdill Career College ......................................... 0057 ERA Northwest School of Real Estate .................0090 Institute of Training - Tualatin ............................0065
Academy of Real Estate Learning...................... 0062 ERA Prestige Homes Real Estate School ............0042 Prudential Real Estate Professionals ...................0582
Advance Real Estate School.............................. 0021 ERA School of Real Estate - Portland ..................0076 Prudential Seaboard Career School .....................1002
Advantage Real Estate School - Beaverton ....... 0024 ERA School of Real Estate - Toledo ....................0098 Quality Real Estate School - Bend .......................1007
Advantage Real Estate School - Gresham......... 0045 Eugene Vocational School ...................................1034 Quality Real Estate School - Medford ..................1031
Advantage Real Estate School - Portland .......... 0070 Excel Real Estate School .....................................0091 Real Estate Academy ...........................................0078
All Professionals School of Real Estate ............. 1026 Hallmark Real Estate School................................1033 Real Estate and Insurance Schools of Oregon.....0060
All State Real Estate School .............................. 0084 Heritage Real Estate School ................................0064 Real Estate and Insurance Trainers .....................1037
American College of Real Estate Jackson County School of Real Estate ................0058 Real Estate Institute, Inc. – Oregon City...............0046
and Appraisal .................................................. 0071 John L. Scott Real Estate Academy/ Real Estate Institute of Oregon - Eugene .............0035
Appraisal and Real Estate School of Oregon ..... 0059 Oregon City .......................................................0068 Real Estate School of Brookings ..........................0027
Ashland Real Estate School............................... 0022 John L. Scott Real Estate Academy/ Real Estate School of Lane County......................0031
Blue Mountain Community College .................... 0446 Portland Metro...................................................0074 Real Estate School of Oregon - Eugene...............0036
Careers Real Estate School ............................... 1025 John L. Scott Real Estate Academy/ Rogue Community College...................................0441
Cascade Real Estate School ............................. 0483 Washington Square ...........................................0075 Sherm Heater Inc School of Real Estate ..............0043
Center for Professional Studies.......................... 0095 John L. Scott - Salem ...........................................1029 Showcase Real Estate School .............................0052
Central Oregon Community College .................. 0437 Klamath County School of Real Estate ................0050 South Coast Center for Professional Studies .......0482
Century 21 Big River Real Estate School........... 0032 Lane Community College .....................................0440 Southern Oregon School of Real Estate...............0044
Century 21 Clackamas Realty School................ 0028 Lighthouse Real Estate School ............................0099 Southern Oregon State College ...........................0425
Century 21 Columbia Crest ................................ 1018 Lincoln City Real Estate School ...........................1023 Southwestern Oregon Community College ..........0438
Century 21 Elite School of Real Estate .............. 0086 Lincoln County Real Estate School ......................0055 Tillamook County Real Estate School ..................0097
Century 21 Franklin Realty - Baker City ............. 0023 Linfield College.....................................................0430 Train Agents, Inc. .................................................1030
Century 21 Franklin Realty - John Day .............. 0048 Linn-Benton Community College..........................0435 Treasure Valley Community College ....................0444
Century 21 Harris & Taylor Real Estate School . 0041 Lois Ebel & Associates Real Estate Inc................0039 TW Resorts Real Estate Inc .................................0040
Century 21 J.C. Jones Realty School................. 1016 Metro Brokers School of Real Estate ...................0141 Umpqua Community College................................0448
Century 21 Mister Real Estate School ............... 0083 Midland Realty Inc Real Estate School ................0056 University of Oregon.............................................0427
Century 21 Pacific Shores Properties Inc., Mt. Hood Community College ..............................0442 University of Portland ...........................................0433
Real Estate School.......................................... 0054 NE Oregon School of Real Estate ........................0061 Warren's Real Estate School................................0038
Century 21 Peninsula School of Real Estate ..... 0073 Norman Webb Real Estate Courses ....................0092 Willamette University School of Law ....................0434
Century 21 Preferred Realtors ........................... 0029 Northwest Realty Consultants Windermere Real Estate/Lane County School .....0037
Century 21 Real Estate Academy - Milwaukie ... 0063 Real Estate School ............................................0383 Windermere Real Estate School - West Linn .......0584
Century 21 Real Estate Academy - Salem ......... 0087 Northwestern School of Law ................................0431 Windermere Real Estate School - Portland ..........0587
Century 21 Real Estate School – Coos Bay....... 0030 onlineEd ...............................................................1003 Windermere/Grants Pass Real Estate School......0462
Century 21 Real Estate School – Eugene.......... 0424 Oregon Coast Community College Woodland Properties Corporation
Century 21 Yaquina Bay Realty School ............. 0066 Service District ..................................................0443 School of Real Estate ........................................0081
Chemeketa Community College......................... 0449 Oregon Institute of Technology ............................0428
Clackamas Community College ......................... 0445 Oregon Real Estate Institute ................................0025 Multiple Schools ...................................................0542
Clatsop Community College............................... 0436 Oregon State University .......................................0426 Unknown ..............................................................9999
Coldwell Banker Mountain West Pacwest Academy................................................0072
Real Estate School.......................................... 0088 Pendleton Southgate Realty School of
Columbia Gorge Community College................. 0439 Real Estate........................................................0069
Coos Country Real Estate School...................... 0589 Portland Community College................................0447
Dynamic Real Estate School.............................. 0089 Portland State University......................................0432
E L Edwards Inc ................................................... 0067 Premier Training Group........................................1017
Eagle Cap Realty Pre-License School ................. 0053 ProSchools/East...................................................0080
Eagle Vision Institute of Real Estate .................... 0096 ProSchools/Salem................................................0094
Eastern Oregon Business College ....................... 0047 ProSchools /West.................................................0079
Eastern Oregon State College ............................. 0429 ProSchools of Klamath Falls ................................0051
ERA Elite Realty Group........................................ 0100 Professional Trainers of Oregon ..........................0085
ERA Herb Clifford Real Estate School ................. 0082 Pro-Studies ..........................................................0026