UMass Extension
Pesticide Education Program

 

2013 Applicator License Training Workshop
Registration Form

Click here to download a two page pdf of the Training Workshops information and registration form.

Please use one form per person

Your Name/Company:
Address:
City: State: Zipcode:
Daytime Phone:
Fax Number:

Please select the location and date of the workshop you wish to attend. Please consider selecting a workshop that is held at least 1 week before your exam.:


Eastern Region Extension Center, Waltham TBA Western Massachusetts UMass Cranberry Experiment Station, East Wareham
January 10 & 11
January 23 & 24
Jan. 31 & Feb. 1
February 13 & 14
February 21 & 22
February 27 & 28
March 14 & 15
March 28 & 29
April 4 & 5
April 11 & 12
April 18 & 19
April 25 & 26
May 2 & 3
May 16 & 17
May 30 & 31
July 8 & 9
August 8 & 9
September 5 & 6
October 3 & 4
November 7 & 8
November 25 & 26

March 21 & 22
May 7 & 8

Feb. 5 & 6
April 9 & 10
For our information, what date will you take the exam?
    What type of work will you be doing? Agriculture
    Exterminating
    Housing Authority
    Landscaping
    Lawncare/Golf Course
    Rights-of-Way
    Schools
    Towns - DPW
    Other:

Reset this Form:

The registration fee is $140.00/person. (This fee only covers the cost of the workshop with refreshments. Pesticide exam study materials and exam fees are not included. Please order your pesticide exam study materials separately as soon as possible)

Make the check or money order payable to University of Massachusetts. Governmental Purchase orders may be submitted via fax (413)545-5858. Tax ID Number is 043-167-352.

Print (2) copies of this form, keep one copy for your records and mail the other copy with your check or money order to:

Pesticide Education
Agricultural Engineering Building, Room 212
250 Natural Resources Road
University of Massachusetts
Amherst, MA 01003-9295

If you have any questions regarding these workshops, call the Pesticide Education office, University of Massachusetts Extension at (413) 545-1044

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