Get Preliminary Application For Certification As A Pesticide Applicator

Filling out the Preliminary Application For Certification As A Pesticide Applicator is an essential step for individuals seeking to obtain certification. This guide will walk you through each section of the form, ensuring that you understand the information required and how to successfully complete it online.

Follow the steps to accurately fill out your application.

1. Click ‘Get Form’ button to obtain the form and open it in the editing platform.
2. Begin by entering your last name, first name, and middle initial in the designated fields. Make sure to print in ink if completing by hand.
3. Fill in your home address, including city, state, and zip code. Ensure that you do not use a P.O. box, as it is not accepted.
4. Provide your telephone number, date of birth, and the last four digits of your Social Security Number (SSN), along with your driver’s license number.
5. Select your type of applicator by checking the appropriate box; either 'Commercial' or 'Public (D.C. or U.S. Government employee)'.
6. Indicate how you are applying by checking the relevant boxes for 'Examination' or 'Reciprocity'. If applying by examination, specify your qualification by checking either 'Experience' or 'Education'.
7. If applicable, indicate if you are currently self-employed, employed by a pest control firm, employed by a government agency, or other. Provide an explanation if you select 'Other'.
8. Answer whether you have ever applied for certification in the District of Columbia by selecting 'Yes' or 'No'.
9. Indicate if you have ever held or currently hold a certificate or license as a certified pesticide applicator in any other state, and if so, list the states.
10. Note if you have ever had a license denied, suspended, or revoked by any licensing agency and provide an explanation if anticipated.
11. Detail your experience in pest control by providing your current and former employer information, including name, address, phone number, employment dates, and duties performed.
12. Select the categories and subcategories in which you wish to be certified by checking the appropriate boxes provided in the form.
13. Certify that the information you provided is accurate and sign the application. Provide the date of your signature.
14. If applicable, have the employing pest control operator complete their section by signing and providing their contact information.
15. Review your completed application for accuracy and completeness. Once verified, you can save changes, download, print, or share the form as needed.

Complete your application online today to ensure a smooth certification process.