North Carolina 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

NORTH CAROLINA 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:
/

*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

	Beetles That Attack Wood: Identifying Beetles That Will Reinfest	1 CCU(W), 1 CCU(F)
	Beetles That Attack Wood: Identifying Beetles That Will Not Reinfest	1 CCU(W), 1 CCU(F)
	The Eastern Subterranean Termite	1 CCU(F)
	The Environmental Protection Agency (EPA) and Its Role In Pesticide Application	3 CCU(G)
	The Federal Insecticide, Fungicide and Rodenticide Act (FIFRA)	3 CCU(G)
	Identifying Cockroaches In and Around the Home	1 CCU(P)
	Managing Pesticide Drift	1 CCU(G)
	Pesticide Applicator Safety	3 CCU(G)
	Recognition and Control of Some Small Vertebrate Pests	1 CCU(P)


Total Number CEUs Ordered: TOTAL AMOUNT DUE: .

How did you hear about us: Mailer Friend Agency Internet
Other

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PestNetwork.com, Inc.

COURSES