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PURDUE PESTICIDE PROGRAMSPURDUE UNIVERSITY COOPERATIVE EXTENSION SERVICE
Pesticide ApplicatorPesticide ApplicatorTrainingTraining
20132013Core and Commercial CatCore and Commercial Categoryegory
2013 Pesticide Applicator Training
Registration FeeThe fee is $60, per person, per program. Personal or company checks, money orders, purchase orders, and MC, VISA, or Discover cards are accepted. The fee does not include study manuals, meals, or lodging. Preregistration is requested. There is a 10% fee for registration cancellations or transfers. Purdue Pesticide Programs reserves the right to cancel programs at any time. Purdue University is not responsible for costs incurred due to cancellation.
Study MaterialsYou are encouraged to order a study manual ($30 ea) for each program for which you register. Training is geared toward those who have studied the manual prior to training. There are NO refunds on study manuals.
Program ScheduleTraining programs begin at 8:30 a.m. (local time). Attendees should arrive between 7:30 and 8:25 a.m. to fi nalize registration. Programs conclude at approximately 3:30 p.m., with the exam offered immediately after. All programs are held at the William Daniel Turf Center, 1340 Cherry Lane, West Lafayette, IN 47906, unless otherwise indicated. Note that these programs are for initial certifi cation ONLY. Recertifi cation credits will not be awarded.
Photo Identifi cationThe Offi ce of Indiana State Chemist requires that all persons taking a certifi cation exam present a government issued photo ID. This includes any valid state driver license, military identifi cation, passport, state issued identifi cation card, or federal agency identifi cation. No other identifi cation will be accepted.
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[Circle which training session(s) you will attend]
To RegisterMail form with payment to: Purdue Extension The Education Store 700 Ahlers Drive West Lafayette, Indiana 47907-2012 Phone: 765/494-6794 or 888/398-4636
orFax form with credit card or P.O. information to: 765/496-1540
To register on-line: https://mdc.itap.purdue.edu/wk_group.asp?wk_group=Pesticide
For More Information
For conference information, contact Cindy Myers Purdue Pesticide Programs 915 W. State Street West Lafayette, IN 47907-2054 Phone: 765/494-4566 or 888/398-4636 E-mail: [email protected]
For program content and certifi cation information, contact Andrew Martin Purdue Pesticide Programs 915 W. State Street West Lafayette, IN 47907-2054 Phone: 765/494-4567 or 888/398-4636 E-mail: [email protected]
or go to:
www.ppp.purdue.edu/certifi cation.html
Purdue Pesticide Programs will not permit electronic re-cording, either audio or video, of any portion of pesticide applicator training conducted under their direction.
(CW-2013-C) January 23, 2013 CORE William Daniel Turf Center
(CW-2013-C) February 6, 2013 CORE William Daniel Turf Center
(CW-2013-C) February 7, 2013 CORE William Daniel Turf Center
(CW-2013-1) February 12, 2013 Category 1 William Daniel Turf Center Agriculture
(CW-2013-3a) February 13, 2013 Category 3a William Daniel Turf Center Ornamental
(CW-2013-3b) February 14, 2013 Category 3b William Daniel Turf Center Turf
(CW-2013-C) February 19, 2013 CORE William Daniel Turf Center
(CW-2013-C) February 20, 2013 CORE Primo West Banquet & Conference Center, Plainfi eld
(CW-2013-3b) February 26, 2013 Category 3b William Daniel Turf Center Turf
(CW-2013-6) February 28, 2013 Category 6 William Daniel Turf Center Industrial Weed
(CW-2013-7a) March 4, 2013 Category 7a William Daniel Turf Center Industrial Pest
(CW-2013-1) March 6, 2013 Category 1 William Daniel Turf Center Agriculture
(CW-2013-3b) March 7, 2013 Category 3b William Daniel Turf Center Turf
(CW-2013-C) March 12, 2013 CORE William Daniel Turf Center
(CW-2013-C) March 13, 2013 CORE William Daniel Turf Center
(CW-2013-C) March 14, 2013 CORE William Daniel Turf Center
(CW-2013-12) March 26, 2013 Category 12 William Daniel Turf Center WDI
(CW-2013-C) April 2, 2013 CORE William Daniel Turf Center
(CW-2013-C) April 4, 2013 CORE William Daniel Turf Center
(CW-2013-C) May 15, 2013 CORE William Daniel Turf Center
(CW-2013-C) June 4 2013 CORE William Daniel Turf Center
(CW-2013-C) July 2, 2013 CORE William Daniel Turf Center
(CW-2013-C) September 10, 2013 CORE William Daniel Turf Center
(CW-2013-12) September 17, 2013 Category 12 William Daniel Turf Center WDI
(CW-2013-C) October 8, 2013 CORE William Daniel Turf Center
(CW-2013-C) November 12, 2013 CORE William Daniel Turf Center
(CW-2013-C) December 3, 2013 CORE William Daniel Turf Center
Registration Form (Please type or print clearly)
Name _________________________________________
Company ______________________________________
Telephone (_____) _____________________________Mailing Address (Training manuals will be sent to this address. No P O Box numbers, please)
__________________________________________________________________________________________________________________________________________City __________________________________________State _______________ Zip _______________________E-mail ________________________________________
1) Please send me a training manual for the program(s) indicated ($30.00 each) $___________
2) Shipping Rate (see table below) $___________3) Indiana sales tax (add lines 1 and 2 above and multiply by .07) $___________4) Training registration fee ($60.00 each) $___________Total amount enclosed (add lines 1 through 4 above) $___________
Shipping rate
.00 - $ 25.00 $ 5.85 $ 25.01 - $ 74.99 $ 8.35 $ 75.00 - $ 99.99 $12.85
(Payment or Purchase Order Number is required prior to attending the program.)
Enclosed is a check or money order payable to
Purdue University.
Enclosed is a purchase order.
P.O. Number: ________________________________
Charge to (check one):
MasterCard VISA Discover
Account Number ________________________________
Exp. Date ______________________________________
Signature ______________________________________
Auxiliary aids and services are required due to a disability. Please contact this registrant at the above phone number.
P e s t i c i d e A p p l i c a t o r T r a i n i n g , 2 0 1 3
Register only one person per form. You may photocopy this form as needed.