Feb. 12, 2025

The Alerus Center, Grand Forks, ND

Registration: Time to be announced

Training: Time to be announced

Fields with asterisk are required.

Core Status *: Ground Core
Air/Ground Core
Select Categories - No refunds issued for incorrect category selection *: Ag Pest Control [+$25.00]
Right of Way [+$25.00]
Seed Treatment-REQUIRES PRIOR APPROVAL PLEASE CALL [+$25.00]
Name of Applicator *
ND Certification # (if renewing)
Date of Birth *
Home Street Address *
PO Box (if applicable)
City *
State *
Zip Code *
ND County of Residence *
Email Confirmation Letter to: *
Secondary Email Address (if applicable)
Cell Phone Number *
Mail Certification Card to: *
Certification Status---choose all that apply *: Applicator
Dealer
Consultant
Is this for Research & Demonstration Purposes? *
Do you have an employer? *
Employer Name *
Employer Street Address/PO Box *
Employer City *
Employer State *
Employer Zip Code *
Employer Phone # *
Do you work for a government agency? *

$75.00

Qty: