HomeMy WebLinkAboutR. Allen, L. Harms, W. Ingamells, J. Schmitz - Ornamental & Turfgrass Applicators Class - 3/5/2021TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
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LEFT AFTER THIS
REQUEST
DATE
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NAME(S) AND POSITION(S): DATE:
Roger Allen -mechanic, Lawrence Harms, Wade Ingamells, 01 /26/2021
Jordan Schmitz PMII
NAME OF CLASS / MEETING:
Ornamental & Turfgrass Applicators class
DESTINATION: ISU Extension Office, Waterloo
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING: 1
PURPOSE OF TRAVEL/TRAINING:
To attend Pesticide Applicator class to maintain license as required in the job description.
Registration is $35 if paid by 2/24/2021 $45 if paid after 2/24
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST $
METHOD OF TRAVEL:
x CITY VEHICLE
AIRFARE
ESTIMATE OF COST:
LODGING
MEALS
YES NO
PRIVATE VEHICLE
DEPARTING FROM:
TAXI
PARKING
35.00 REGISTRATION AIRFARE
MILEAGE/FUEL MISC/TOLLS
TOTAL FOR ALL: $ 140.00
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
K:\Shared Goodies\Forms\Travel Request Form January 2010
BUDGET LINE ITEM: 010-37-41001364
x GRANT REIMBURSABLE
YES NO
x
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 35.00 PER PERSON
I APPROVE THIS TRAVEL REQUEST
G4_�
MAYOR
DATE
Ornamental and Turfgrass Applicators Registration
Continuing Instruction Course (CIC) in Categories 30, 3T, and 30T
Wednesday, March !W, 2021, 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
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8:30 a.m. Check-in 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:
• Application Equipment Use, Maintenance, and Calibration
• Safe Application Techniques Including Pesticide Drift Reduction
• Pests and Pest Management including Phytotoxicity as appropriate
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.
This institution is an equal opportunity provider. For the full non-discrimination statement or
accommodation inquiries, go to www.extension.iastate.edu/diversity/ext
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Ornamental and Turfgrass Applicators Registration
Continuing Instruction Course (CIC) in Categories 30, 3T, and 30T
Wednesday, March -S 2021, 9:00 a.m. - 11:30 a.m.
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Only one registration per form. Please duplicate for additional registrations.
1 will attend the session at
Name
Company Mailing Address*
City/State/Zip
Fax
Email
Company
Work Phone
County.
*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.)
Preregistration is Required. Walk-ins are not guaranteed admission.
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 February 24, 2021
Late Registration, $45, after February 24, 2021 (less than seven days prior to the
program or on-site registration).
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.