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Alabama Department of Agriculture & Industries Pesticide Forms

The Alabama Department of Agriculture and Industries has an extensive list of forms that are required for Pesticide Permits.  We have created a extensive list of their forms, linked to the forms were possible and listed the rest in order to have all this information available to you on one Page. Please visit our individual Commercial Applicator Permit category pages to get more specific information for each Category.

ADAI Pesticide Management Contacts:

Contacts:
General email address (goes to Chelsea & Barbara):   cert@agi.alabama.gov

Chelsea Wolfe – (334) 240-7243 chelsea.wolfe@agi.alabama.gov

  • General information regarding commercial applicators and horticulture categories and testing information.

Barbara Gates – (334) 240-7240 barbara.gates@agi.alabama.gov

  • Certification (permit cards), reciprocation, and recertification meetings/points

Dorothy Gresham – (334) 240-7286 dorothy.gresham@agi.alabama.gov

  • Custom applicator Information

Joe Debrow – Program Director: (334) 240-7233 joe.debrow@agi.alabama.gov

  • Professional Services applicator Information

Bridget Pope – Structural: (334) 240-7261  bridget.pope@agi.alabama.gov 

  • Professional Services  applicator Information

Lisa Kervin – Horticulture: (334) 240-7269  lisa.kervin@agi.alabama.gov

  • Professional Services  applicator Information

Karen Daniels – (334) 240-7242 OR karen.daniels@agi.alabama.gov

  • Restricted Use Dealer

Forms

Please NOTE: Some of the links go directly to the form required and some of the links go to the page that houses the forms. Please view the whole document below to determine what resources you need.

ADAI Certification and Testing Information Page

ADAI Custom Applicators Information Page

ADAI Pesticide Registration Information Page

These Forms below are available as PDF Downloads on the ADAI site:

  • Pesticide Registration – 25(b) Registration Form 
  • Pesticide Registration – New Product Application A-M
  • Pesticide Registration – New Product Application N-Z
  • Pesticide Registration – Point of Contact Form

ADAI Pesticide Rules and Regulations

ADAI Professional Services Information Page

ADAI Restricted Use Dealer Page

ADAI Clean Day Pesticide Disposal Program

ADAI Worker Protection Standard Information Page

ADAI Ag Container Recycling Council Information Page

ADAI Pesticide Management Main Page Forms

These Forms below are available as PDF Downloads on the ADAI site:

  • Certification – Application for Commercial Applicator Permit (First Permit and Add-On)
  • Certification – Application for Commercial Applicator Permit (Reciprocal)
  • Certification – Application for Commercial Applicator Permit (Renewal)
  • Certification – Application for Professional Services Exam 2018
  • Certification – Change of Information Form for Commercial Applicators (Not Businesses)
  • Certification – Change of Information Form for Commercial Applicators (Not Businesses)
  • Certification – Schedule for Custom Pesticide Applicator Exams 2018-2019
  • Certification – Schedule for Professional Services Exams 2018
  • Custom Applicators – Bond for Custom Application of Pesticides
  • Custom Applicators – Change of Info For Custom Pesticide Applicators
  • Custom Applicators – Custom Business License Application
  • Pesticide Registration – 25(b) Registration Form
  • Pesticide Registration – New Product Application A-M
  • Pesticide Registration – New Product Application N-Z
  • Pesticide Registration – Point of Contact Form
  • Private Applicators – Application for a Private Applicator Permit
  • Professional Services – Bond To Perform Subterranean Termite Work
  • Professional Services – Certificate of Insurance
  • Professional Services – Change of Information Form for Operators
  • Professional Services – Consumer Complaint Form
  • Professional Services – License Application (Branch Office)
  • Professional Services – License Application (Horticultural)
  • Professional Services – License Application (Main Office)
  • Professional Services –  License Application (Sub Office)
  • Professional Services – Official Alabama Waiver Form (Termites)
  • Professional Services – Statement of No Loss
  • Restricted Use Pesticide Dealers – License Application
  • Restricted Use Pesticide Dealers – Log Book
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