HomeMy WebLinkAboutSeveral personnel - Aquatic, FOrest, ROW, Pest Mgmnt Classes - 10/16/2019 FINANCE DEPT. STAFF ONLY
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Original-Clerk/Finance ' Copy- epartment
NAME(S) AND POSITION(S): DATE: C liL &fit 40 4100 e,4
Glenn Bearbower, Crager Cook, Luke Even, Phillip 9/16/2019
Thompson, Robert Thompson Forestry Wade Ingamells,
Eric Pecenka, Jordan Schmitz Park Greg Svoboda, Collin
'vViddel Downtown Bob Jorgensen Golf
TNAME OF CLASS/ MEETING: DESTINATION: Waterloo IA
Aquatic, Forest, Right-of-Way, Pest Management
Continuing Instruction Course DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING:
10/16/19 10/16/19 10/16/19
PURPOSE OF TRAVEL/TRAINING:
Attend Pesticide Applicators training to obtain required CEUs. The CEUs are required to maintain pesticide applicators
license as required by job description.
Early Registration of$35 is due before October 9.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST$
YES NO
PJIETHOD OF TRAVEL:
X CITY VEHICLE PRIVATE VEHICLE
_ AIRFARE DEPARTING FROM:
010-37-4110 1346 $70 010-37-4120 1346$35
ESTIMATE OF COST: BUDGET LINE ITEM: 010-37-4100-1346 $280
LODGING TAXI X GRANT REIMBURSABLE
MEALS PARKING YES NO
$385.00 REGISTRATION AIRFARE X REQUIRED CERTIFICATION
MILEAGE/FUEL MISC/TOLLS YES NO
TOTAL FOR ALL: $ 385.00 TOTAL: $ 35 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CIT ATERLOO
P TMENT H MAYOR
bA\*af eoo Cies orms rave Request orm i 7Mary 2010 DATE
Aquatic, Forest and Right-of-Way, Pest
Management Registration
Continuing lnstruct�on Course (CIC) in Categories 2, 5,d6, and 10
Wednesday, October 16, 2019, 9:00 a.m. - 11:30 a.m.
Only one registration per form. Please duplicate for additional registrations.
1 will attend the session at Extension Office.
Name Company
Company Mailing Address*
City/State/Zip
Fax ( ) Work Phone ( )
Email
*Has your address changed? Please write the Pesticide Bureau, Iowa Department of Agriculture and
Land Stewardship, 502 E. 9th Street, Wallace Building, Des Moines, IA 50315 with your new address,
so you continue receiving notification of pesticide applicator courses. Iowa State University requests
this information for the purpose of preregistering you in a conference. No one outside the university,
with the exception of participants in this conference, is routinely provided this information. If you fail
to provide the required information, we cannot promise accurate registration. (Reference: Iowa Code,
Chapter 22.11; Iowa Fair Information Practices Act.)
TO REGISTER
Send the completed form with payment to your local extension office where you will attend.
Additional registration forms are available on the Web at www.extension.iastate.edu/psep
or your local county extension office. Make check payable to the local county extension office
(e.g., "Adams County"). Write the names of all individuals on the check if only one check will
pay the registration fee for several individuals.
REGISTRATION FEE
Early Registration, $35, due by October 9, 2019
Late Registration, $45, (less than seven days prior to the program or on-site
registration) after October 9, 2019.
PAYMENT TO LOCAL COUNTY OFFICE MUST BE ENCLOSED WITH FORM.
The fees for service will be used to off-set direct expenses and to support the Agriculture &
Natural Resources County Extension Program.
REGISTRATION IS COMPLETE UPON PAYMENT.
Aquatic, Forest and Right-of-W►ay, Pest
Management Registration
Continuing Instruction Course (CIC) in Categories 2, 5, 6, and 10
Wednesday, October 16, 2019, 9:00 a.m. - 11 :30 a.11n.
Who Should Attend
This course is designed for certified commercial pesticide applicators needing yearly
certification credits in the following categories:
• 2 - Forest Pest Control
• 5 - Aquatic Pest Control
• 6 - Right-of-Way Pest Control
• 10 - Demonstration and Research
Program
8:30 a.m. Registration at local site. To receive credit, you must be seated prior to
9:00 a.m.
8:55 a.m. Local Welcome.
9:00 a.m. Introduction.
Program to include:
• Recognition of sensitive areas, including groundwater and other
non-target sites and organisms (pollinators)as potentially impacted by
pesticide applications, drift and runoff.
• Pests, pest management and pesticides
• Pesticide labels
• Restricted Entry Intervals and Prehalrvest Intervals
11:30 a.m. Adjourn
This program is sponsored by Iowa State University Extension and Outreach
Pesticide Safety Education Program (PSEP). If you have questions about program
content, please call us at (515) 294-1122. If you have special needs or need closed
captioning for viewing the program, please contact the site you will attend.
Iowa State University Extension and Outreach does not discriminate on the basis of age,disability,ethnicity,gender identity,genetic
information,marital status,national origin, pregnancy,race,color,religion,sex,sexual orientation,socioeconomic status,or status as a U.S.
veteran,or other protected classes.(Not all prohibited bases apply to all programs.) Inquiries regarding non-discrimination policies may be
directed to the Diversity Advisor,2150 Beardshear Hall,515 Morrill Road,Ames,Iowa 50011,515-294-1482,extdiversity@iastate.edu.All other
inquiries may be directed to 800-262-3804.