Pesticide Notification for Parents or Guardians

Dear Parent or Guardian:

A Minnesota state law went into effect in year 2000 that requires schools to inform parents and guardians if they apply certain pesticides on school property.

Specifically, this law requires schools that apply these pesticides to maintain an estimated schedule of pesticide applications and to make the schedule available to parents and guardians for review or copying at each school office. This schedule is located in the school office.

State law also requires that you be told that the long-term health effects on children from the application of such pesticides or the class of chemicals to which they belong may not be fully understood.

If you would like to be notified prior to pesticide applications made on days other than those specified in the estimated schedule (excluding emergency applications), please complete and return the form below. You may also contact Superintendent David Bottem by calling Barnum Public Schools at 218-389-6978.

Request for Pesticide Notification
At Barnum Public Schools

I understand that the school will make available an estimated schedule of pesticide applications for review and copying at the school office. Should a pesticide application be scheduled on a day different from the day(s) specified in the original schedule, I would like to be notified. I understand that the school may ask me for reimbursement for the costs of notification.

I would prefer to be notified by (circle): US Mail E-mail

Please print neatly:

Name of Parent/Guardian:_______________________________________Date:___________


Day Phone:(___)_________Evening Phone:(___)__________E-mail:_____________________

Return this form to:
Superintendent David Bottem, 3675 County Road 140, Barnum, MN 55707