Pesticide Advisory Committee Nomination Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The Pesticide Advisory Committee is accepting nominations for one position:

- Registered Limited Commercial Applicator Representative

- Organic Grower Representative - Actively engaged in organic agricultural production

Deadline is October 12, 2023

Use this form to submit your nominations.

For more information about the PAC and the positions currently accepting nominations can be found at https://ag.colorado.gov/pesticide-advisory-committee

Email *

In accordance with Title 35, Article 10, of the Pesticide Applicators' Act:

The state agricultural commission created by section 35-1-105 shall appoint an advisory committee of fifteen members to advise the commissioner on agricultural, human health, environmental, wildlife, worker safety, and other matters regarding the use of pesticides in Colorado and to assist the commissioner in promulgating rules to carry out this article.

First Name *

Middle Name

Last Name *

Residence or Cell Phone No. *

Home Address *

City *

State *

Zip Code *

Your Occupation

Present Employer

Business Phone No.

Business Address

Position for which you are applying - Choose only one *

A Registered Limited Commercial Applicator Representative - (Must be a Qualified Supervisor)

Organic Grower Representative - actively engaged in organic agricultural production

General Public Representative - NOT actively engaged in urban agricultural production

Colorado State University Representative

Other:

Clear form

Never submit passwords through Google Forms.

This form was created inside of State.co.us Executive Branch. Report Abuse

Forms