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About
Who We Are
Join or Renew
Staff
Leadership
GCAR Board of Directors
Leadership Opportunites
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Advocacy
Members
Professional Standards
Across the Association
Health Insurance
Member Login
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Resources
RE Technology
Realtor Property Resource
Blog
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Student Attestation Form
Today's Date
*
Date Format: MM slash DD slash YYYY
This will certify that I, and no one else, completed the Live Distance Education course known as:
*
(Insert class title)
The course is approved for _______ hours of New York State continuing education credit.
*
1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6
6.5
7
7.5
8
22.5
The course was completed on:
*
Date Format: MM slash DD slash YYYY
Student Name
*
First
Last
Student Email
*
Student Phone
*
Student Mailing Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
11-Digit License Registration Number:
*
(Located on your DOS-issued Pocket Card)
Confirmation
*
I certify under penalty of perjury and false swearing that I am the student who took the above course and that this typed signature has the same legal effect and can be enforced in the same way as a written signature.
Signature
*
Type your first and last name