Applications & Forms

Some commonly used forms by certified applicators or licensed dealers.

Applicator Application (Commercial, Non-Commercial and Government Applicators only)

This application is available at the testing location, or can be filled out ahead of time and brought to the testing location at exam time.  Please do not submit applications prior to taking certification exams.  See pesticide exams page for more information.

Application for a certificate to apply pesticides (pdf)

 

Pesticide Company License Application (For employers of Commercial Applicators only)

This application can be filled out by a comapny officer ahead of time and brought to the exam location at exam time.  This is only needed if the employer does not already hold a VT pesticide company license.

Pesticide Company License Application (pdf)

 

Annual Usage Report Form (Commercial, Non-Commercial and Government Applicators only)

This form is sent only to the certified applicator types named above each year with their renewal paperwork.  Must be completed and returned to the Agency with the renewal paperwork in order to renew the certificate, whether or not any pesticides were applied in the previous year.

Annual Usage Report Form (pdf)

 

Pesticide Dealer Application (Class A and Class B Dealers only)

This application is available at the testing location, or can be filled out ahead of time and brought to the testing location at exam time.  When renewing, Dealers must submit the Restricted Use Sales & Storage Report.  The Restricted Use Sales Form should be used for maintaining records of sales at the dealership.

Pesticide Dealer License Application (Class A or B) (pdf)

See Retail Licensing Section for Class C Pesticide Licensing

Restricted Use Sales & Storage Report

Restricted Use Sales Form