Registration Form

The LORICK School... Quality Real Estate Instruction

Rick Raulin – Instructor
Email: RickRaulin@aol.com
Cell Phone: (608) 628-0973

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The Lorick School Student Information Sheet

Thank you for attending The LORICK School for your Continuing Education needs. We appreciate your business! If you would be so kind, would you please fill out this registration form as completely as you can – that way, you can avoid having to put a lot of the same information on your answer sheets for each of the six course modules, and I can readily capture information on your attendance record for you, your company & Board of REALTORS (if you are actively practicing), and for the State of Wisconsin, when they ask me for it. This information is used exclusively by The LORICK School and will not be disseminated in any way. Thanks for your cooperation.

Rick Raulin

Personal Information

First Name:
Middle:
Last Name:
Address:
City:
State:
Zip:
Real Estate Lic #:
Email:
Nickname:
Personal Website:

Business Information (Leave blank if not actively practicing real estate at this time)
Company Name:
Company Address:
City:
State:
Zip:
Company Phone:
Company Fax:
Company Website:
Are you a REALTOR? (yes/no):
If Yes, Board Name: