Pesticide Applicator Registration

First Name:

Last Name:

Email:

Confirm Email:

Password:

Password must have a minimum of 8 characters with at least one uppercase, one numeric and one special character

Confirm password:

Phone Number:

Existing Applicator:

Applicator ID:

License#:

If you do not know your Applicator Id or License#, please call (502) 573-0282

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