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054.00.31 Appendix 2. Change in Curriculum or Instructor or Proctor for use with Rule 31

AR ADC 054.00.31 Appendix 2Arkansas Administrative CodeEffective: February 7, 2016

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 31. Pre-License Education for Producers
Effective: February 7, 2016
Ark. Admin. Code 054.00.31 Appendix 2
054.00.31 Appendix 2. Change in Curriculum or Instructor or Proctor for use with Rule 31
Currentness
To: Arkansas Insurance Department
Licensing Division
1200 West Third
Little Rock, AR 72201-1904
Name: ____________________________________________________________
Name of Pre-licensing Education Course Provider:
________________________________________
 
Provider Number:
____________________________________________________________
 
Course Number:
____________________________________________________________
 
Name of contact person:
____________________________________________________________
 
Telephone Number:
____________________________________________________________
 
Address:
____________________________________________________________
 
Email Address:
____________________________________________________________
 
Facility or Course Provider Website:
_______________________________________________________
 
The following changes have been made in our Course Curriculum and/or Instructors/Proctors:
ATTACH THE APPLICABLE CHANGES
1.
Course Outline and Type of Study (Classroom or Electronic)
2.
List of Resource Materials
3.
Names of Instructors/Proctors and Qualifications
4.
Names of instructors serving as Designated Officials of Provider
5.
Names of proctors serving for electronic courses; disclose if you are serving as a Designated Official of the Provider
________________________________________
Typed Name of Pre-licensing Education Course Provider Official
________________________________________
Signature of Pre-licensing Education Course Provider Official
____________________
Date
FOR DEPARTMENT USE ONLY
APPROVED BY:
DATE:
DISAPPROVED BY:
DATE:

Credits

Amended Feb. 7, 2016.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.31 Appendix 2, AR ADC 054.00.31 Appendix 2
End of Document