"Application for Professional Services Examination(S)" - Alabama

Application for Professional Services Examination(S) is a legal document that was released by the Alabama Department of Agriculture and Industries - a government authority operating within Alabama.

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Alabama Department of Agriculture and Industries
APPLICATION FOR PROFESSIONAL SERVICES EXAMINATION(S)
RETURN TO:
Dept. of Agriculture & Industries
Date:
Pesticide Management Division
Location: ____Montgomery___________
Email or fax to:
CERTIFICATION SECTION
cert@agi.alabama.gov
IMPORTANT NOTE:
1445 Federal Drive
Fax: 334-240-7168
Montgomery AL 36107-1123
Phone: 334-240-7243
PLEASE READ APPLICATION
I hereby make application for examination in the field(s) of:
CAREFULLY.
1. HORTICULTURE SUPERVISOR
IF THE APPLICATION IS NOT
* Qualifications Required – See note below.
COMPLETED FULLY, IT WILL
a. Landscape Horticulturist -- Landscape Design (LD)
BE RETURNED TO YOU FOR
b. Landscape Planter -- Setting of Landscape Plants (SLP)
FURTHER INFORMATION. THIS
c. Tree Surgery (TS)
COULD CAUSE YOU TO MISS
THE EXAM DATE!!!
d. Ornamental and Turf Pest Control Supervisor (OTPS)
2. STRUCTURAL PEST CONTROL (Certified Operator)
** Qualifications Required – See note below.
EXAM(S) SCHEDULED FOR:
MARCH
JUNE
SEPT
DEC
a. Household, Institutional and Industrial Pest Control (HPC)
b. Fumigation Pest Control (FC)
ON
DAY, 2018
c. Control and/or Eradication of Wood Destroying Organisms (WDC)
NOTE: APPLICATIONS MUST BE
3. STRUCTURAL PEST CONTROL (Branch Supervisor)
SUBMITTED AT LEAST 7 DAYS
** Qualifications Required – See note below.
PRIOR TO THE EXAM DATE.
a. Household, Institutional and Industrial Pest Control (HPB)
APPLICATION DEADLINE:
b. Fumigation Pest Control (FB)
c. Control and/or Eradication of Wood Destroying Organisms (WDS)
MARCH
JUNE
SEPT
DEC
4. CUSTODIAL PESTICIDE APPLICATOR
1 2 3 4 5 6 7 8 9
*** Qualification Required – See note below.
10 11 12 13 14 15 16 17 18
a. Industrial, Institutional and Health Related Pest Control (IIHC)
19 20 21 22 23 24 25 26 27
b. Ornamental and Turf Pest Control (OTPC)
28 29 30 31
5.
a.
RECERTIFICATION EXAM
QUALIFICATION STATEMENT MUST BE
NOTE: *, **, *** See Reverse Side for Qualification Requirements.
SUBMITTED WITH APPLICATION!
This is my FIRST time to take an examination in any category.
I have PREVIOUSLY taken an examination (any category) in AL.
Records are on file in the AL Agriculture office.
If you have been issued a certification permit number with AL, what is your permit number
SEND NO MONEY NOW, PAY AT EXAM SITE!
PLEASE PRINT LEGIBLY
LEGAL NAME
LAST 4 OF SSN
HOME ADDRESS
PO BOX
HOME PHONE
CITY
COUNTY
STATE
ZIP
NAME OF FIRM
FIRM ADDRESS
PO BOX
FIRM PHONE
CITY
STATE
ZIP
This application is for paper-based testing.
To apply for computer-based testing on one of
_________________________________________________________
our statewide testing sites, please apply at
SIGNATURE
http://apply.adaitesting.com
Alabama Department of Agriculture and Industries
APPLICATION FOR PROFESSIONAL SERVICES EXAMINATION(S)
RETURN TO:
Dept. of Agriculture & Industries
Date:
Pesticide Management Division
Location: ____Montgomery___________
Email or fax to:
CERTIFICATION SECTION
cert@agi.alabama.gov
IMPORTANT NOTE:
1445 Federal Drive
Fax: 334-240-7168
Montgomery AL 36107-1123
Phone: 334-240-7243
PLEASE READ APPLICATION
I hereby make application for examination in the field(s) of:
CAREFULLY.
1. HORTICULTURE SUPERVISOR
IF THE APPLICATION IS NOT
* Qualifications Required – See note below.
COMPLETED FULLY, IT WILL
a. Landscape Horticulturist -- Landscape Design (LD)
BE RETURNED TO YOU FOR
b. Landscape Planter -- Setting of Landscape Plants (SLP)
FURTHER INFORMATION. THIS
c. Tree Surgery (TS)
COULD CAUSE YOU TO MISS
THE EXAM DATE!!!
d. Ornamental and Turf Pest Control Supervisor (OTPS)
2. STRUCTURAL PEST CONTROL (Certified Operator)
** Qualifications Required – See note below.
EXAM(S) SCHEDULED FOR:
MARCH
JUNE
SEPT
DEC
a. Household, Institutional and Industrial Pest Control (HPC)
b. Fumigation Pest Control (FC)
ON
DAY, 2018
c. Control and/or Eradication of Wood Destroying Organisms (WDC)
NOTE: APPLICATIONS MUST BE
3. STRUCTURAL PEST CONTROL (Branch Supervisor)
SUBMITTED AT LEAST 7 DAYS
** Qualifications Required – See note below.
PRIOR TO THE EXAM DATE.
a. Household, Institutional and Industrial Pest Control (HPB)
APPLICATION DEADLINE:
b. Fumigation Pest Control (FB)
c. Control and/or Eradication of Wood Destroying Organisms (WDS)
MARCH
JUNE
SEPT
DEC
4. CUSTODIAL PESTICIDE APPLICATOR
1 2 3 4 5 6 7 8 9
*** Qualification Required – See note below.
10 11 12 13 14 15 16 17 18
a. Industrial, Institutional and Health Related Pest Control (IIHC)
19 20 21 22 23 24 25 26 27
b. Ornamental and Turf Pest Control (OTPC)
28 29 30 31
5.
a.
RECERTIFICATION EXAM
QUALIFICATION STATEMENT MUST BE
NOTE: *, **, *** See Reverse Side for Qualification Requirements.
SUBMITTED WITH APPLICATION!
This is my FIRST time to take an examination in any category.
I have PREVIOUSLY taken an examination (any category) in AL.
Records are on file in the AL Agriculture office.
If you have been issued a certification permit number with AL, what is your permit number
SEND NO MONEY NOW, PAY AT EXAM SITE!
PLEASE PRINT LEGIBLY
LEGAL NAME
LAST 4 OF SSN
HOME ADDRESS
PO BOX
HOME PHONE
CITY
COUNTY
STATE
ZIP
NAME OF FIRM
FIRM ADDRESS
PO BOX
FIRM PHONE
CITY
STATE
ZIP
This application is for paper-based testing.
To apply for computer-based testing on one of
_________________________________________________________
our statewide testing sites, please apply at
SIGNATURE
http://apply.adaitesting.com
* QUALIFICATIONS FOR SUPERVISOR: Quoting from Regulations Governing Professional Work or
Services Pertaining to Entomological Work, Pathological Work, Horticultural and Floricultural Work, and Tree
Surgery Work:
Alabama law states that applicants for certification as Supervisor for professional work or services
pertaining to Ornamental and Turf Pest Control, Landscape Horticultural and Floricultural Work and Tree
Surgery shall submit a written statement outlining their training and experience in professional work or
services for which examination is requested. Statement should include employer’s name, dates employed and
type of work performed. NOTE:
,
IF YOU REFERENCE EDUCATIONAL EXPERIENCE
INCLUDE COPIES OF COURSE
!
WORK
** QUALIFICATIONS FOR CERTIFIED OPERATOR OR BRANCH SUPERVISOR: Quoting from
Regulations Governing Professional Work or Services Pertaining to Entomological Work, Pathological Work,
Horticultural and Floricultural Work, and Tree Surgery Work:
Alabama law states that applicants for certification as Certified Operator or Branch Supervisor for
professional work or services defined as structural pest control work must have a knowledge of the practical and
scientific facts underlying the practice of structural pest control and the necessary knowledge and ability to
recognize and control those hazardous conditions, which may affect human life and health. Applicants for
certification as Certified Operator or Branch Supervisor for structural pest control shall be duly permitted to
take the examinations for the various subcategories of structural pest control and shall submit to the
Commissioner evidence of qualifications, which shall include as minimum qualifications one (1) or more years
of working experience as an employee or owner-operator in the field of structural pest control for which
certification is applied for; or a college degree, which includes instructions in Entomology satisfactorily
completed; or one (1) or more years training or equivalent training in structural pest control work under
educational institutional supervision may be substituted for one (1) of actual working experience. Qualification
statement should be on employer’s letterhead and be signed by owner or office manager. Include dates
employed and type of work performed.
***
CUSTODIAL PESTICIDE APPLICATOR: Quoting from Regulations Governing the Sale,
Offering for Sale, Classification, Use, Transportation, and Distribution of Pesticides in Alabama.
Custodial Pesticide Applicator means a commercial applicator who uses or supervises the use of
restricted use pesticides for purposes other than production of an agricultural commodity on property owned,
leased, or otherwise in control of another person as part of his permanent salaried employment for the owner,
lessor, or person in control of the property. NOTE: This classification is for permanent salaried persons
working for golf courses, apartment complexes, municipalities, food distribution centers, etc.
Applicants shall submit a written statement outlining their training and experience in professional
work or services for which examination is requested. Statement should include employer’s name, dates
employed and type of work performed.
• Examinations are held on the third Tuesday in March, June, September, and
December.
• Applicants must submit applications to this office at least seven days prior to an
examination date. Applications received after this date will be considered for
the next examination date.
• Applicants will be notified of acceptance or rejection of application prior to
the date of examination.
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