Pesticide Workbook Request Form

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Pesticide Workbook Request Form

Please complete this form. Upon completion, we will mail a copy of the Pesticide Recertification Workbook to the applicator listed. For questions, contact Andy Kness, akness@umd.edu or Erika Crowl, ecrowl@umd.edu.

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Applicator Information

Please provide the information below for the applicator requesting the workbook

Applicator first name *

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Applicator last name *

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Street address *

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City *

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State *

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Zip code *

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Applicator phone number *

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