"Commercial Pesticides Trainee Registration Application" - Kentucky

Commercial Pesticides Trainee Registration Application is a legal document that was released by the Kentucky Department of Agriculture - a government authority operating within Kentucky.

Form Details:

  • The latest edition currently provided by the Kentucky Department of Agriculture;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Kentucky Department of Agriculture.

ADVERTISEMENT
ADVERTISEMENT

Download "Commercial Pesticides Trainee Registration Application" - Kentucky

312 times
Rate (4.7 / 5) 19 votes
DEPARTMENT OF AGRICULTURE
DIVISION OF ENVIRONMENTAL SERVICES
107 CORPORATE DRIVE
FRANKFORT KY 40601
Commercial Pesticides
Trainee Registration Application
($5.00 Fee) Payable to: KY STATE TREASURER
Trainee Name: _____________________________________________________
First, Middle, Last: __________________________________________________
Home Address: ____________________________________________________
City: __________________________________ State: _______ Zip _________
Home Phone: (_______) _____________________
Company CO#: ___________________
Company Name: ___________________________________________________
Company Address: __________________________________________________
City: ________________________________ State: _______ Zip: ________
We, the undersigned, acknowledge that the Commercial Pesticide Trainee listed above is being hired
for a period not to exceed ninety (90) consecutive working days and is not renewable. We further
understand that the Trainee is required to be under the direct supervision of a licensed Commercial
Pesticide Operator or Applicator at all times.
_____________________________________ ____________________
Signature of Trainee
Date
_____________________________________ ____________________
Signature of Authorized Personnel
Date
DEPARTMENT OF AGRICULTURE
DIVISION OF ENVIRONMENTAL SERVICES
107 CORPORATE DRIVE
FRANKFORT KY 40601
Commercial Pesticides
Trainee Registration Application
($5.00 Fee) Payable to: KY STATE TREASURER
Trainee Name: _____________________________________________________
First, Middle, Last: __________________________________________________
Home Address: ____________________________________________________
City: __________________________________ State: _______ Zip _________
Home Phone: (_______) _____________________
Company CO#: ___________________
Company Name: ___________________________________________________
Company Address: __________________________________________________
City: ________________________________ State: _______ Zip: ________
We, the undersigned, acknowledge that the Commercial Pesticide Trainee listed above is being hired
for a period not to exceed ninety (90) consecutive working days and is not renewable. We further
understand that the Trainee is required to be under the direct supervision of a licensed Commercial
Pesticide Operator or Applicator at all times.
_____________________________________ ____________________
Signature of Trainee
Date
_____________________________________ ____________________
Signature of Authorized Personnel
Date