Continuing Education Units (CEU)

Sign Up Form

 

Sign Up Below to Establish a New Account.

NOTE: Information with an * is required.
This information is used to build a pesticide license database file for you.

Please enter the following information to establish your user profile.
Note: This information is used only to track your on-line CEU course information, and to provide required information to the Texas Department of Agriculture. The information provided WILL NOT be provided to any other party.

First Name *
 		MI
 		Last Name *
  
  TDA License # *
 		Expiration Date *(mm/dd/yyyy)
  Address 1 *
 		Address 2 *
  City *
 		State *
 		Zip Code *
  Phone *
 Email *
 		Fax Number *
  Company
 Company Address
 Social Security #
  Password *
 		Password Confirm *