Pesticide Notification Registry

To: Parents, Guardians, and School Staff

From: Canaan Community Academy

Subject: Pesticide Application Registry Notice

Date: 1/5/16


Canaan Community Academy practices integrated pest management, a program which combines preventative techniques, non-chemical pest control methods and the appropriate use of pesticides with a preference for products that are the least harmful to human health and the environment. Applications of pesticides are made only when deemed necessary to control a pest problem and after trying other means to control the problem. The term “pesticide” includes insecticides, herbicides, rodenticides, and fungicides.

We are establishing a registry of persons who wish to be notified 48 hours prior to pesticides applications. To be included in this registry, please complete the form below and return it to Canaan Community Academy.


Please include me in the notification registry. I understand that if there is an immediate threat to health or property that requires treatment before notification can be sent out, I will receive notification as soon as it is practical.


Parent/Guardian/Staff Members Name                                                                 

Signature                                                               Date                                                

Student’s Name                                                                                                  


Email address                                                       Phone number