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PESTICIDESCHOOLREGISTRATIONFORMSPRING2023NAME(Pleaseprintclearly)
STREETADDRESS
CITY, STATE, ZIP
PHONENUMBER/EMAILADDRESSMAILTO:PesticideSafetyEducation
Dept.ofHorticulturalScience
NCSUCampusBox7609
Raleigh,NC276957609
Pleasereadinstructionsonthefirstpage.
Payandregisterforonlyonesubcategory
evenifyouplantotestinmorethanone.
FEESMADEPAYABLETONCSU:
CommercialApplicator$60
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