Pesticide license affidavit 

All current Class A members, as well as Superintendent Members striving to achieve Class A status, are required to provide proof of possessing a valid pesticide license or pass the GCSAA IPM exam 

If you have taken the IPM exam, you do not need to submit this form. Please review your transcript to ensure the exam is documented on your record.

All fields are required.

Pesticide license number: 
Licensed issued by (i.e., state, province, or country):   
License Expiration:   
   By attesting and selecting this checkbox, I am hereby attesting that all information is correct and authorize GCSAA to make any inquiries deemed necessary for validation. I understand that falsification of this information breaches the GCSAA Code of Ethics and that GCSAA will be conducting random audits.

Note to Certified Golf Course Superintendents (CGCS):
If you are a certified golf course superintendent (CGCS) you must have recorded your pesticide license by July 1, 2008, or have taken the GCSAA IPM Exam. Meeting the pesticide requirement will then be required in all subsequent renewal cycles.