Phytophthora Online Exam Registration Form

Once your registration and payment information has been recorded by OSU Extended Campus, you will receive your exam login information via email. Note: If you will be using a Company Purchase Order, please call Extended Campus at 800-235-6559 or email ecampus@oregonstate.edu.
*Asterisks () indicate required information.**
Note: Those taking the exam to earn four pesticide recertification credits through the Oregon Department of Agriculture need to enter their pesticide applicator license in the appropriate field below when registering.
* First Name:
* Last Name:
* Address Line 1:
Address Line 2:
* City:
* State:
* Zip Code:
Nation:
* Phone Number:
* Email:
* Your intended method of payment:
Pesticide License Number:
Are you currently employed by a nursery?	Yes No
If yes, what type of nursery?
Name of Nursery:
Nursery Address Line 1:
Nursery Address Line 2:
Nursery City:
Nursery State:
Nursery Zip Code:
How did you hear about this online course?
If Other (please specify):

OSU Extended Campus