Pesticide Applicator CEU Recertification Form
Once you submit this form, DEC will re-issue your certification, valid for three years from issue date. Your existing certification will then be invalid. Do not submit this form unless you are close to expiration of your current certification.
*
I understand
Applicant Information
Name
*
First Name
Last Name
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Current certified applicator number
Current certified applicator expiration date
*
-
Month
-
Day
Year
You cannot recertify via CEUs once certification is expired. If certification is expired, you must take exams to obtain certification. See https://dec.alaska.gov/eh/pest/certified-applicators/becoming-certified/
Employer
Do you currently have an employer?
Yes
No
Name of Company/Agency
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Continuing Education Unit (CEU) Information
List ONLY DEC approved courses.
Click to expand course input...
Input your courses
*
Rows
Date
Course Title
Location
Organization
# of CEUs
1
2
3
4
5
6
7
8
9
10
11
12
Total CEUs
Minimum of 12 CEUs required to apply for recertification.
Certification Category
Categories of recertification request
*
Regulatory Pest Control
Pesticide Consultation and Demonstration
Agricultural Pest Control
Ornamental and Turf Pest Control
Antifouling Paint
Aquatic Pest Control
Structural Pest Control
Public Health Pest Control
Right-of-Way and Industrial Pest Control
Mosquito and Biting Fly Pest Control
Aerial Pest Control
Forest Pest Control
Restricted-Use Pesticide Control
Pesticide Research
Soil Fumigation
Non-Soil Fumigation
Vertebrate Pest Control
Vertebrate Pest Control -- Rodents only
Vertebrate Pest Control -- Predators only
Oilfield Biocides
Pesticide Technician
Website Posting
Would you like to be included on DEC's online list of certified applicators?
Yes
No
Signature
*
Date
*
-
Month
-
Day
Year
Date
Please verify that you are human
*
Submit
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