Appendix A - Sample forms for fulfilling the requirements of the Healthy Schools Act Warning Sign- P 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'Name of Pesticide' in the designated field. Ensure that you provide the exact name as registered.
3. Next, fill in the 'Name of Manufacturer' to identify who produces the pesticide. This information is crucial for compliance.
4. Input the 'US EPA Registration No.' which is essential for tracking and regulatory purposes.
5. Specify the 'Intended Application Date' to inform stakeholders when treatment is planned.
6. Record the 'Actual Application Date' once treatment has been completed, ensuring accurate documentation.
7. Provide a brief explanation in the 'Reason for Treatment' section to clarify why this pesticide was applied.
8. For recordkeeping, enter the 'Amount of Pesticide Used' to maintain compliance with Healthy Schools Act requirements.
9. Finally, include your contact details under 'For more information about this pesticide application contact:' ensuring that all relevant parties can reach you easily.

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