COLORADO BOARD OF MORTGAGE LOAN ORIGINATORS TWO (2) HOUR ANNUAL COLOADO UPDATE CONTINUING EDUCATION COURSE APPLICATION

Please Note: All sections of this form are required. Incomplete applications will result in application denial. Course Provider: Contact Person: Address:

Telephone No:

City/State/Zip:

E-Mail:

Hereby applies for approval to offer mortgage loan originator continuing education (CE) credit for the following course: Course Title: Delivery Method: □ Live Lecture Course Length: ______hours This course will be (first) offered: (Attach course schedule if available)

□ Interactive Web-based □ CD-ROM Requested hours of CE Credit: Date: Location:

□ Correspondence (paper) _____hours

I am a provider who is:

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1. Approved by the Division of Private Occupational Schools (DPOS). 2. Exempt from DPOS oversight pursuant to section 12-59-101, et seq.

The Board of Mortgage Loan Originators requires you to supply any and all relevant information that supports the above attestations. If you are DPOS approved, you are required to provide documentation and proof of such approval. If you are exempt from DPOS approval, you must provide proof of such exemption.

I have enclosed the following required documentation in support of this application:

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1. A copy of the instructor(s)’ occupational teaching credential; OR résumé including educational, professional and teaching qualifications to present this course 2. Appropriate user ID and password to access courses offered On-line: _______________________

In addition to these requirements, the Board reserves the right to request additional information to determine the validity of the course submission. If you feel there is information beyond the listed requirements that would assist the Board in making a determination, please include that information with your application. All courses being taught online must be consistent and compliant with the Nationwide Mortgage Licensing System’s Functional Specifications for NMLS Approved Continuing Education (CE) Online Courses Manual. This may be reviewed at: http://mortgage.nationwidelicensingsystem.org/courseprovider/Course%20Provider%20Resources/Online%20CE% 20Funtional%20Spec%2020100315.pdf In addition to myself, I authorize the following person(s) to sign the “Student Course Completion Certificate.” (Send new printed names & signatures on your letterhead to update as necessary during the course approval period.) Printed Name Signature Printed Name

Signature

I certify that I have read and will fully comply with Board rule 1-4-1, entitled Licensing Education, Examination and Continuing Education, and that this course will contribute directly to the professional competence of the licensee. I am responsible for the course and instructor, as well as for retaining course materials and attendance records for 4 years after the last date this course is offered. I will furnish said records to the Board of Mortgage Loan Originators or an authorized representative of the Board in accordance with timelines defined in rule 1-4-1 and upon request. Printed Name (Employing Broker/Director/CEO/etc.) Signature Date

Mail To: ATTN: MLO Education 1560 Broadway suite 925 Denver, CO 80202