InspTngAppl

[Note: Please print a copy of this form and mail or Fax it to the Chair of the Seminars Committee]

APPLICATION TO HOST FEED AND FERTILIZER INSPECTOR TRAINING

Name of state submitting application _________________________________________________

Name of control official and title _____________________________________________________

Suggested location (city) for meeting _________________________________________________

Suggested date for meeting _________________________________________________________

Preliminary information required

o How long has it been since your states’ inspectors have attended an association sponsored training seminar?______________

o Where was the last seminar held that would have been closest to your state?_____________

Year __________

o Have you surveyed the surrounding states to determine their interest in sending inspectors if your state host a seminar?_________

List the name of the other states expressing an interest in sending inspectors to the seminar:

Host State __________	Approx. # of inspectors that will attend _________
State _______________	Approx. # of inspectors that will attend _________
State _______________	Approx. # of inspectors that will attend _________
State _______________	Approx. # of inspectors that will attend _________
State _______________	Approx. # of inspectors that will attend _________
State _______________	Approx. # of inspectors that will attend _________
State _______________	Approx. # of inspectors that will attend _________

Facility and Resource Availability

o Is your selected site easily accessible by ground transportation by several states? __________

o Is your selected site easily accessible by air transportation? __________

o Do you have manufacturers within thirty minutes drive from the meeting place?

Fertilizer Manufacturer __________	Distance from site __________
Feed Manufacturer _____________	Distance from site __________

o Do you have academia resources that could be available to provide instruction in the areas of (1) report writing (2) conflict management (3) taking depositions …etc.?

Submit Application by October of the year before your planned Seminar

Submit application to: AAPFCO Seminar Committee Chairman (See Committee List for name of Chair)

Your Name:______________________________ Title:________________________________

Signature: ____________________________________ State:______________ Date_________