Forms for Your School IPM Program

Pest Management In and Around Structures September 10, 2015 Print Friendly and PDF

 

Here are a list of forms that may be useful in implementing and keeping your school IPM program up and running smoothly. Take these forms and pages of information and create documents that work for your school. Some of these are editable Microsoft Word documents and others are PDFs.

Click here if you do not have Microsoft Word or Adobe Reader.
Sample intent to apply notice (PDF)
Sample cafeteria inspection (PDF)
Sample indoor caution sign (PDF)
Sample audit checklist (PDF)
Sample audit checklist (Word)
Sample audit report (PDF)
Sample audit report(Word)
Sample comprehensive IPM policy (PDF)
Sample comprehensive IPM policy (Word)
Sample contract between school and pest management professional (PDF)
Sample contract between school and pest management professional (Word)
Sample corrective action notice (PDF)
Sample corrective action notice (Word)
Sample letter to parents regarding head lice (PDF)
Sample letter to parents regarding head lice (V.2)(PDF)
Sample school IPM flier (PDF)
Sample school IPM flier (Word)
Sample kitchen pest sighting log (PDF)
Sample kitchen pest sighting log (Word)
Sample school IPM model contract (PDF)
Sample school IPM model contract (V.2)(PDF)
Sample model pest management policy statement (PDF)
Sample pest monitoring protocol (PDF)
Sample pest monitoring protocol (Word)
Sample school IPM success statement (PDF)
Sample school IPM success statement (Word)
Sample school IPM self inspection sheet (PDF)
Sample school IPM self inspection sheet (Word)
Sample school IPM self inspection sheet (V.2) (PDF)
Sample school IPM self inspection sheet (Excel)

Other School IPM Information

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This work is supported by the USDA National Institute of Food and Agriculture, New Technologies for Ag Extension project.