2021 Pesticide Stewardship Conference Registration

21st Annual Pesticide Stewardship Virtual Conference – February 2-4, 2021

Please fill out the registration form below. If you have any issues or questions with this form, please contact us.

Step 1. Contact Information
Name*
First Last
Organization
Email*
Enter Email Confirm Email
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Step 2. Conference Registration
$50 Individual TPSA Member until 1/25/2021 (after: $100.00 for individual TPSA members)
Price: $100.00 Quantity:
$100 Organizational TPSA Member until 1/25/2021 (after $200.00 for Organizational TPSA Member)
Price: $200.00 Quantity:
$75 Non-Member Individual until 1/25/2021 (after $150.00 for Non-Member Individual)
Price: $150.00 Quantity:
TOTAL
$0.00
Enter payment at the end of this form.
Step 3. Membership
(IF YOU HAVE NOT RENEWED YOUR MEMBERSHIP) - The Pesticide Stewardship Alliance - 2021 Membership Form - September 1, 2021 - August 31, 2021 (not a part of Conference Registration)
Individual – $75 (Membership is free to Sponsors contributing $1,500-$5,499.)
Price: $75.00 Quantity:
Provide full name, address, phone number and email below.
Organization – $200 (Membership is free to 3 members per organization in an organizational membership. Also, free to Gold Sponsors contributing $5,500 or more)
Price: $200.00 Quantity:
Provide full name, address, phone number and email below.
TOTAL
$0.00
Step 4. Affiliation of Membership
Each member please select one of the following areas of affiliation that represents your primary personal/professional area of focus within TPSA.
Choosing one affiliation per member does NOT prohibit any TPSA member from being actively involved in any TPSA committee, group, meeting, or voting. Affiliation records serve to assist with Conference planning, Membership assessment, BOD nominations, and overall Organization focus.
- UNITED STATES ENVIRONMENTAL PROTECTION AGENCY (U.S. EPA)
  Individuals employed by the U.S. EPA.
- GOVERNMENT AGENCY
  Individuals employed by a local, state or federal agency (except the U.S. EPA).
- PESTICIDE INDUSTRY
  Entities or organizations that manufacture, formulate or distribute pesticides; manufacture or distribute pesticide containers; conduct pesticide research, education, training or consultation; manufacture, sell or distribute equipment and/or other products that are utilized in any aspect of pesticide manufacture, commerce, packaging, transport, application, use, and storage; and pesticide industry sponsored and funded organizations that undertake pesticide stewardship activities.
- WASTE MANAGEMENT INDUSTRY
  Entities or organizations that identify, package, or transport waste pesticides and residues, recycle waste pesticides and residues and/or pesticide equipment or containers or manufacture equipment to accomplish any of the above; and any waste-management industry sponsored and funded organizations that undertake pesticide stewardship activities.
- PESTICIDE CONTAINER MANAGEMENT INDUSTRY
  Organizations that are involved in any aspect of pesticide container management and any pesticide container management industry sponsored and funded organizations that are involved with pesticide stewardship activities.
- INSTITUTIONS
  Entities that are involved with research, teaching or extension in an area or areas of pesticide stewardship.
- END USERS
  Individuals or businesses that use or apply pesticides and organizations, trade associations or commodity groups that represent end-users or applicators.
- PUBLIC OR ENVIRONMENTAL HEALTH
  Individuals and organizations that are involved with environmental and natural resource protection, recycling, pollution prevention or other conservation or ecological issues and any other corporations that do not fit into any other category.
- NON-AFFILIATED
  Individuals and organizations that do not wish to identify with or do not fit into an area of affiliation listed above.
Step 5. Sponsor Information - Please contact the TPSA office for more info. (314) 849-9137
Step 6. Payment
Payment - pay with credit card or if paying by check, make payment to TPSA with a copy of the registration form and mail to TPSA, 11327 Gravois Road, Suite 201, St. Louis, MO 63126. To pay with credit cards, click below. You do not need to have a PayPal account to use this function. If paying by PayPal and paying for someone besides yourself – please include their name(s) to ensure payment is applied to proper person. * Payable in US dollars. * By paying for conference, attendee gives permission to be contacted by TPSA via email.
GRAND TOTAL
$0.00
*** Pay for your registration securely by clicking the PayPal button below.
You can use the PayPal Guest Checkout to pay with any major credit card. A PayPal account is not required. ***

2021 Pesticide Stewardship Conference Registration

21st Annual Pesticide Stewardship Virtual Conference – February 2-4, 2021

Please fill out the registration form below. If you have any issues or questions with this form, please contact us.

Step 1. Contact Information

Step 2. Conference Registration

Step 3. Membership

Step 4. Affiliation of Membership

Step 5. Sponsor Information - Please contact the TPSA office for more info. (314) 849-9137

Step 6. Payment

The Pesticide Stewardship Alliance

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