"Retake Application Form - Professional Services License / Permit Exam(S)" - Mississippi

Retake Application Form - Professional Services License / Permit Exam(S) is a legal document that was released by the Mississippi Department of Agriculture and Commerce - a government authority operating within Mississippi.

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  • Released on September 1, 2015;
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RETAKE APPLICATION
PROFESSIONAL SERVICES LICENSE / PERMIT EXAM(S)
Please mail or fax this form to the Bureau of Plant Industry, P.O. Box 5207, Mississippi State, MS 39762, fax #
662-325-0397 so that it is received no later than 10 days prior to the exam date. This form must be submitted and
approved to retake failed exam(s), or to take exams because you were unable to attend an examination session that
you had been previously approved for. Submit this form only if application has been previously approved by the
Bureau of Plant Industry and you have not failed the applied for licensing exam twice in consecutive attempts. If
an applicant fails a licensing exam twice in consecutive attempts (after July 27, 2008) the applicant shall submit a
new application, meet the requirements for licensing and wait a full year before taking the exam again. Permit
exams, landscape horticulturist exams, tree surgery exam and general standard exam may be taken until passed.
PLEASE PRINT CLEARLY
DATE___________________
NAME________________________________ _______________________
______________________________
LAST
FIRST
MIDDLE
HOME ADDRESS______________________________________________________________________________
CITY_________________________________________________STATE________ ZIP CODE _______________
E-MAIL ________________________________________PHONE # (
) ________________________________
SIGNATURE ___________________________________________________________________________________
LICENSE
PERMIT
NEW
OLD
DESCRIPTION FOR EXAM
DESIGNATION
DESIGNATION
CATEGORIES
PLEASE MARK
PLEASE MARK
FOR
FOR
WITH X THE
WITH X THE
EXAM
EXAM
(SEE REGULATIONS FOR
EXAMINATIONS
EXAMINATIONS
DETAILED DESCRIPTION)
YOU WISH TO
YOU WISH TO
RETAKE
RETAKE
WDI
1
Wood destroying insect control
UPL
(1)
Control of pests of utility poles
NOT AVAILABLE
GRC
2
General pest and rodent control
MBF
Not applicable
Mosquito and biting fly control
HCP
3
Horticultural pest control
ORP
5 and 8
Orchard pest control
DAP
6
Domestic animal pest control
FUM
9
Fumigation pest control
AGP
10
Agricultural pest control
AGW
A
Agricultural weed control
AQW
B
Aquatic weed control
ROW
C
Right-of-way weed control
HCW
D and E
Horticultural weed control
LSH (PART 1)
7
Landscape horticulturist (part 1)
NOT AVAILABLE
LSH (PART 2)
7
Landscape horticulturist (part 2)
NOT AVAILABLE
TS
4
Tree surgery
NOT AVAILABLE
GS
GS
General Standards Commercial Certification Core
Exam Required, Except for LSH and TS Categories
PLEASE MARK
REGULARLY SCHEDULED EXAMINATION SESSIONS
WITH X (MARK
YOU WILL BE NOTIFIED BY LETTER OF APPROVAL OR DENIAL
ONLY ONE)
nd
2
Tuesday of January
nd
2
Tuesday of April
nd
2
Tuesday of July
nd
2
Tuesday of October
FORM REVISED SEPT 2015
RETAKE APPLICATION
PROFESSIONAL SERVICES LICENSE / PERMIT EXAM(S)
Please mail or fax this form to the Bureau of Plant Industry, P.O. Box 5207, Mississippi State, MS 39762, fax #
662-325-0397 so that it is received no later than 10 days prior to the exam date. This form must be submitted and
approved to retake failed exam(s), or to take exams because you were unable to attend an examination session that
you had been previously approved for. Submit this form only if application has been previously approved by the
Bureau of Plant Industry and you have not failed the applied for licensing exam twice in consecutive attempts. If
an applicant fails a licensing exam twice in consecutive attempts (after July 27, 2008) the applicant shall submit a
new application, meet the requirements for licensing and wait a full year before taking the exam again. Permit
exams, landscape horticulturist exams, tree surgery exam and general standard exam may be taken until passed.
PLEASE PRINT CLEARLY
DATE___________________
NAME________________________________ _______________________
______________________________
LAST
FIRST
MIDDLE
HOME ADDRESS______________________________________________________________________________
CITY_________________________________________________STATE________ ZIP CODE _______________
E-MAIL ________________________________________PHONE # (
) ________________________________
SIGNATURE ___________________________________________________________________________________
LICENSE
PERMIT
NEW
OLD
DESCRIPTION FOR EXAM
DESIGNATION
DESIGNATION
CATEGORIES
PLEASE MARK
PLEASE MARK
FOR
FOR
WITH X THE
WITH X THE
EXAM
EXAM
(SEE REGULATIONS FOR
EXAMINATIONS
EXAMINATIONS
DETAILED DESCRIPTION)
YOU WISH TO
YOU WISH TO
RETAKE
RETAKE
WDI
1
Wood destroying insect control
UPL
(1)
Control of pests of utility poles
NOT AVAILABLE
GRC
2
General pest and rodent control
MBF
Not applicable
Mosquito and biting fly control
HCP
3
Horticultural pest control
ORP
5 and 8
Orchard pest control
DAP
6
Domestic animal pest control
FUM
9
Fumigation pest control
AGP
10
Agricultural pest control
AGW
A
Agricultural weed control
AQW
B
Aquatic weed control
ROW
C
Right-of-way weed control
HCW
D and E
Horticultural weed control
LSH (PART 1)
7
Landscape horticulturist (part 1)
NOT AVAILABLE
LSH (PART 2)
7
Landscape horticulturist (part 2)
NOT AVAILABLE
TS
4
Tree surgery
NOT AVAILABLE
GS
GS
General Standards Commercial Certification Core
Exam Required, Except for LSH and TS Categories
PLEASE MARK
REGULARLY SCHEDULED EXAMINATION SESSIONS
WITH X (MARK
YOU WILL BE NOTIFIED BY LETTER OF APPROVAL OR DENIAL
ONLY ONE)
nd
2
Tuesday of January
nd
2
Tuesday of April
nd
2
Tuesday of July
nd
2
Tuesday of October
FORM REVISED SEPT 2015