Pest Management Notification Form

It you want to be notified 24 hours in advance of a planned pesticide application, please full out this form.

Integrated Pest Management Initial Notification Form

School Year*
Child/Children's Name (if applicable)
Dear Parent/Guardian, District Employee, or Health Professional:

Children's Learning Tree, Inc. has implemented a special program of Integrated Pest Management (I.P.M.) in or to control pest in a way that minimizes economic, health, and environmental risks via a monitoring and inspection program and judicious use of pesticides. Those individuals applying pesticides will be properly certified in keeping with applicable legal requirements for the I.P.M. program.

If you want to be notified 24 hours in advance of a planned pesticide application, other than when bait is used, or as soon as possible when an emergency pesticide application is necessary, please fill out this form and give to the director for filing. This form will need to be updated annually.
Would you like to be notified 24 hours in advance?*
- Yes
- No
Type name then sign below*
Signature
Date*
MM slash DD slash YYYY

Enrollment Forms

Family Registration Form

New to The Children's Learning Tree of Somerset? Please fill out the form to register your child (children) for any of our childcare services.

Emergency Preparedness Form

Please fill out the emergency preparedness form so you and your children will be prepared should an emergency situation arise.

First Aid

Please fill the First Aid information form out so we may treat your child in the event your child needs medical attention and we are unable to contact you.

Pest Management Form

Would you like to be notified when we are treating our facility for pests? Please let us know and we will provide a 24 hour notice.

Service & Payment Authorization

Our fees are due a week in advance on a weekly basis. Please read our payment policy and sign our contract. Should you have questions, or need to make alternate arrangements, please contact us.