1. Healthcare

Category F / J*
AQUATICS /
Rights-of-Way*
Pesticide Applicator
Recertification Workshop
(includes Category A Core)
* Must hold F: Aquatics license to attend
for J: Rights-of-Way
Recertification Information
Pesticide applicators licensed in Category A (CORE)
and Category F (Aquatic) and Category J (Rightsof-way) are required to recertify by either attending
an approved Category F (Aquatics) and Category J
(Rights-of-way) workshop every other year.
By attending the recertification workshop in 2015, you
will not need to recertify until 2017. Remember to
renew your license annually, too.
The Minnesota Department of Agriculture reserves the
right to deny recertification to those who arrive late
or who are not in attendance during portions of the
program. Attendance is monitored.
All pesticide applicators are required to renew their
licenses annually with the Minnesota Department of
Agriculture.
Please bring your applicator license identification card
to the workshop.
Best Western Kelly Inn
Wednesday, March 11, 2015
8:30 a.m. – 5:00 p.m.
(original size)
Pesticide Safety & Environmental Education
495 Borlaug Hall
1991 Upper Buford Circle
Saint Paul, MN 55108
100 4th Avenue South
St. Cloud, MN 56301
Registration for non DNR employees only.
DNR employees should
register internally through the DNR.
http://www.extension.umn.edu/pesticides/2015/2015recert.html
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Planned Agenda
Pesticide licensing, compliance., and inspections
Pesticide applications on Tribal Lands
Best practices for noxious weeds
Lake reclamation
Pollinators and Pesticides
Zebra mussel control
Forestry & Right-of-Way invasive species
The University of Minnesota, including the Extension Service, is
committed to the policy that all persons shall have equal access to
its programs, facilities, and employment without regard to race,
religion, color, sex, national origin, handicap, age, veteran status, or
sexual orientation.
Registration Form
AQUATICS (Cats. A & F & J)
Pesticide Applicator Training Workshop
March 11, 2015
Use separate forms copy for additional registrants
Registration Information
All
registrations
include A: Core
Category F
Category F & J
Early Fee
by
March 4, 2015
$129
$169
Regular Fee
after
March 4, 2015
and at the door*
$144
$184
*Walk-ins accepted if seats are available.
This registration site/form for non-DNR employees
only.
DNR employees should register internally
through the DNR.
Location
Best Western Kelly Inn
100 4th Avenue South
St. Cloud, MN 56301
Tel: 320 253-0606
Workshop Schedule - March 11, 2015
Check-in begins: 8:30 a.m.
Program begins: 9:00 a.m.
Categorie F&J program adjourns: 5:00 p.m.
Lunch is not provided.
There are restaurants located
near the workshop facility.
Minnesota Licensing Questions
Contact the Minnesota Department of Agriculture
651-201-6615; fax 651-201-6105
Web site: www.mda.state.mn.us
For Workshop Information
Contact Mary Kay Ferguson
Pesticide Safety & Environmental Education,
University of Minnesota
612-625-4271 or [email protected]
How to Register
1. By Secure Internet
Online registration at our Web site:
http://www.extension.umn.edu/pesticides/2015/2015recert.html
2. By Mail
Mail registration form and payment to:
ATTN: Extension Registration
130 Learning & Environmental Sciences
1954 Buford Avenue
St. Paul, MN 55108
Payment
1. We accept checks by mail. DO NOT send credit card info in the mail.
2. VISA or MasterCard accepted.
3. Please print when you fill in the registration form.
4. Use separate forms for each individual. Registration form may be photocopied.
5. If you register fewer than five days before the workshop, please register online.
Name_________________________________________
Company______________________________________
Billing Address_________________________________
City__________________________________________
State______________ Zip Code____________________
Day Telephone_________________________________ Fax __________________________________________
E-mail________________________________________
Pesticide License No.____________________________
White/non-Hispanic
Black Asian or Pacific Islander American Indian or American
Native Hispanic
Gender: Male
Female
Ethnicity:
Registration and Fee Options
Cancellations
Cancellation received in writing up to five working
days before the workshop is refundable, minus a $35
administrative fee. After that, refunds are not issued.
Please note that if you don’t cancel and don’t attend,
you are still responsible for payment.
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Change in Registration
$35 per change in registration
When substituting, we must have a completed registration form for that person.
Must contact Mary Kay Ferguson prior to the workshop to make any changes to your registration. No exceptions.
No show registrants will be considered a non-
refundable cancellation.
Contact Mary Kay Ferguson when needing to make a substitution or change:
Tel: 612-625-4271; email: [email protected]
Category
Early Fee
(by 3/4/15)
Regular Fee
(after 3/4/15)
Enclosed
Fee
A, F
$129
$144
$
A, F and J
$169
$184
$
TOTAL $
 Enclosed is a check or money order payable to the University of Minnesota in U.S. funds, drawn from
a U.S. bank.
 Please bill my organization (purchase order or
letter of authorization attached).
 Please charge my U of MN EFS Account:
Fund Dept-ID ProgramEmp-ID