Tennessee Registration Form

PestNetwork.com, Inc.

P.O. Box 81552
Austin, TX 78708-1552 FAX: (512) 990-0665
Phone: (512) 990-3216

CREDIT CARD INFORMATION MUST MATCH CREDIT CARD NUMBER

TENNESSEE Registration

Credit Card Registration:

*Cardholder Name (First, Middle Initial):

*Cardholder Name (Last):

*Mailing Address:

*City:

*State / Zip:
/

Applicators Information if different from Cardholder:

First Name:

Last Name:

Mailing Address:

City:

State / Zip:
/

Social Security #:

*App. License # State Abbrev.:

Expiration Date:

* Phone:

Fax:

*Email:

* Represents required fields.

You must complete all credit hours registered for within the ceu time frame period that you registered in.

No credit hours will carry forward.

COURSES
	Texas Laws and Regulations	2 POINTS cat. ALL

	Applicator Safety	1 POINT cat. ALL

	Beetles That Attack Wood: Identifying Beetles that will reinfest	2 POINTS cat. 2-7-10-12

	Beetles That Attack Wood: Identifying Beetles that will not reinfest	2 POINTS cat. 2-7-10-12

	The Eastern Subterranean Termite	2 POINTS cat. 7-10-12

	Environmental Protection	1 POINT cat. ALL

	Facets of IPM Field Crops	1 POINT cat. 1-10-12

	Identifying Cockroaches In and Around the Home	2 POINTS cat. 7-8-10-12

	Insect Pests That Attack Cotton - The Boll Weevil	1 POINT cat. 1-10-12

	Know Your Cotton Plant	1 POINT cat. 1-10-12

	Managing Drift	1 POINT cat. ALL

	Pesticide Families	1 POINT cat. ALL

	Principles of IPM Field Crops	1 POINT cat. 1-10-12

	Principles of Pest Control on Lawn and Turf	2 POINTS cat. 3

	Sucking Pests of Ornamental Shrubs	1 POINT cat. 2-3-10-12

Total Number CEUs Ordered: TOTAL AMOUNT DUE: $ .

How did you hear about us: Mailer Friend Agency Internet
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PestNetwork.com, Inc.

COURSES