HomeMy WebLinkAboutC. Harn - Ornamental and Turfgrass Applicators Class - 11/13/2019 FINANCE DEPT. STAFF ONLY
LINE ITEM U5E1) mco
TRAVEL REQUEST FYAY b BUDGETED /OUD
CITY OF WATERLOO EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE _?Rid y''/8
Original- Clerk/Finance Copy-Department
NAME(S) AND POSITION(S): DATE:
Casey Harn, Golf Maintenance 11 11/13/2019
NAME OF CLASS/ MEETING: DESTINATION: Waterloo IA
Ornamental and Turfgrass Applicators Class
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING:
11/13/19 11/13/19 11/13/19
PURPOSE OF TRAVEL/TRAINING:
To attend Pesticide Applicator class to maintain license as required in this job position.
Early registration of$35 is due before November 6, 2019.
�VILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST$
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM: 010-37-4120-1346
LODGING TAXI X GRANT REIMBURSABLE
MEALS PARKING YES NO
35.00 REGISTRATION AIRFARE X REQUIRED CERTIFICATION
MILEAGE/FUEL MISC/TOLLS YES NO
TOTAL FOR ALL: $ 35.00 TOTAL: $ 35.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
19
DEPARTMENT HEAD MAYOR
DATE DATE
K:AShared Goodies\Forms\Travel Request Form January 2010
Ornamental and Turfgrass Applicators Registration
Continuing Instruction Course (CIC) in Categories 30, 3T, 30T, and 10
Wednesday, November 13, 2019, 9.00 a.m. - 11:30 a.m.
Only one registration per form. Please duplicate for additional registrations.
I will attend the session at County.
Name Company
Company Mailing Address*
City/State/Zip
Fax ( ) Work Phone ( )
Email
*Has your address changed? Please write the Iowa Department of Agriculture and Land Stewardship,
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. Note that the Story County program will be held at
the Story County Extension Office.
REGISTRATION FEE
Early Registration, $35, due by November 6, 2019
Late Registration, $45, (less than seven days prior to the program or on-site
registration) after November 6, 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.
Ornamental and Turfgrass Applicators Registration
Continuing Instruction Course (CIC) in Categories 30, 3T, 30T, and 10
Wednesday, November 13, 2019, 9:00 a.m. - 11:30 a.m.
Who Should Attend
This course is designed for certified commercial pesticide applicators needing yearly
certification credits in the following categories:
• 30 - Ornamental Pest Control
• 3T - Turf Pest Control
• 30T - Ornamental and Turf 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 as Potentially Impacted by Pesticides
• Worker Protection Standard and Restricted Entry Intervals
• Pesticide Labels
• Pests, Pest Management, and Pesticides
11:30 a.m. Adjourn
This program is sponsored by Iowa State University Extension 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.