Member Application

If you would like to become a valued member of TPSA, you have the option of a convenient PayPal form to apply and pay your fee in one step below, or you can download the application form and mail it in. The membership year is from September 1, 2023 – August 31, 2024.

Download the mail-in form

Or Pay Online Below

STEP 1. Contact Information for Individual or Organization Member
Membership Status*
- New Member
- Renewal
Name*
First Last
Title
Company/Business
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
STEP 2. Membership
Please select your membership preference below and enter a number one (1) to the quantity box.
Individual Membership/Renewal – $100.00 Quantity
Price: $100.00
Choose Your Affiliation
AFFILIATION
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, province, 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.
Organization – $250.00 Quantity
Price: $250.00
Hidden
Number
PRIMARY MEMBER NAME: (name of person NOT organization)
Identify up to 3 members in your organization for TPSA membership. Your Primary Contact should be listed first.
First Last
Email
Phone
Affiliation
Choose Your Affiliation
AFFILIATION
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 ENVIRONEMTNAL PROTECTION AGENCY (U.S. EPA)
  Individuals employed by the U.S. EPA.
- GOVERNMENT AGENCY
  Individuals employed by a local, province, 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.
MEMBER NAME 2: (name of person NOT organization)
First Last
Email
Phone
Affiliation
Choose Your Affiliation
AFFILIATION
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, province, 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.
MEMBER NAME 3: (name of person NOT organization)
First Last
Email
Phone
Affiliation
Choose Your Affiliation
AFFILIATION
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, province, 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.
Retired Membership/Renewal – $35 Quantity
Price: $35.00
Last Job & Title
Student – $25 Quantity
Price: $25.00
List School
AFFILIATION
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, province, 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.
YOUR TOTAL
$0.00
Comments
STEP 3. Payment
Clicking the PayPal check out button below, you are agreeing to our Terms and Condions.
YOUR TOTAL
$0.00
Pay securely with debit or credit card by clicking the PayPal button below.
You will be re-directed to the PAYPAL website.
A PayPal account is not required to make payment.
You can use your own credit/debit card

Member Application

STEP 1. Contact Information for Individual or Organization Member

STEP 2. Membership

STEP 3. Payment

Pay securely with debit or credit card by clicking the PayPal button below.
You will be re-directed to the PAYPAL website.
A PayPal account is not required to make payment.
You can use your own credit/debit card

The Pesticide Stewardship Alliance

Quick Links

Login

Member Application

STEP 1. Contact Information for Individual or Organization Member

STEP 2. Membership

STEP 3. Payment

Pay securely with debit or credit card by clicking the PayPal button below. You will be re-directed to the PAYPAL website. A PayPal account is not required to make payment. You can use your own credit/debit card

The Pesticide Stewardship Alliance

Quick Links

Login

Pay securely with debit or credit card by clicking the PayPal button below.
You will be re-directed to the PAYPAL website.
A PayPal account is not required to make payment.
You can use your own credit/debit card