Pesticide Forms
Certification and Licensing Forms
1. Certificate of Surety Bond for WDO, General Pest and Rodent, Bird, and Fumigation Structural
2. Certificate of Surety Bond for all other categories
3. Application: Pest Control Applicator License and Charter
4. Application to Take License Exam
5. Link to Online Certification Exam
6. Study Material Order Form (through UT online)
7. Commercial Certification Applicator Information Sheet
8. Application for the Registration of Pesticides in Tennessee
8. Application for CEU’s/Points
10. Continuing Education Units Required to Maintain Certification
11. Application for Replacement Card or Change of Address
12. Application for Restricted Use Pesticide Dealer License
13. Application for Aerial Applicator License
14. How to Obtain an Aerial Applicator License and Aircraft Decal
15. Roster Form
16. Apprentice Termite Technician School Registration Form - April
17. Apprentice Termite Technician School Registration Form - September
18. Charter Employee Removal Form
Contacts
Pesticide Product Registration - For making general-use and restricted-use pesticide products available for sale in Tennessee. Contact: Hannah Decker- 615-837-5054 – hannah.decker@tn.gov
Pesticide Dealer Licensing - For selling restricted-use pesticide products in Tennessee. Contact: Justin Caldwell - 615-532-3918- justin caldwell@TN.gov
Pesticide Applicator Testing - For commercial certification testing. Contact: Bonnie Voyles Potter - 615-837-5188 – bonnie.potter@tn.gov
License Issuance - For establishing and maintaining the right to apply pesticides for a fee in Tennessee. Contact: John Ewell - 615-837-5340 - john.ewell@TN.gov
Pesticide Issues - For pesticide enforcement, including consumer related complaints concerning a pesticide application. Contact: Jim Endsley - 615-837-5138 - jim.endsley@TN.gov
Certification and Licensing - For use of any general-use and restricted-use pesticides as either a private or commercial applicator, schools approved for points, license exams. Bonnie Voyles Potter - 615-837-5188 – bonnie.potter@tn.gov | Private Applicators - Chad Hayes – 615-837-5339 – chad.hayes@tn.gov.
Aerial Issuance – For aerial requirements and issuance of decals. Contact: Justin Caldwell - 615-532-3918- justin caldwell@TN.gov
Structural Issues – For structural issues pertaining to the application of termiticides. Contact Paul Sizemore – 615-542-2739 – paul.sizemore@tn.gov
EPA Programs and Pesticide Disposal - For Endangered Species, Groundwater, Pesticide Disposal and Worker Protection including the requirements to train agricultural employees and pesticide handlers. Contact Jim Endsley – 615-837-5138 – jim.endsley@tn.gov
Worker Protection Training Verification Cards - For verification of training or to obtain Worker Protection training verification cards to show that training has occurred. Contact: Jim Endsley – 615-837-5138 – jim.endsley@tn.gov.
For All Other Questions
For all other questions regarding the Pesticides or Pest Control program, contact Kathy Booker, Administrator - 615-837-5133 -kathy.booker@TN.gov.