48-hour notification pursuant to Section 409-h of the State Education Law.*

____________________________________

Dear Parent, Guardian, and School Staff: (date)

Pursuant to State Education Law Section 409-H, this notice is to inform you of a pending pesticide application

to the_____________________________________________________________________________school

facility. You may wish to discuss with _________________________________________________, the

(insert name)

designated school representative, what precautions are being taken to protect your child from exposure to these pesticides. Further information about the product(s) being applied, including any warnings that may appear on the label of the pesticide(s) that are pertinent to the protection of humans, animals, or the environment, can be obtained by calling the National Pesticide Telecommunications Network Information Phone Number (1-800-858-7378) or the New York State Department of Health Center for Environmental Health Info Line at (1-800-458-1158).

Required Information

Information Details

Application Date

Application Location

Product to be Used

EPA Pesticide Registration Number

As a reminder, the following pesticide applications are not subject to prior notification requirements:

For information on products that are scheduled to be applied in this school please feel free to contact the School

District (or nonpublic school) pesticide representative _____________________________________________

(name)

at may be reached at: _______________________________________________________________________

(insert address, telephone, e-mail address, and FAX)