Request Form

1. Requester:

Update label based on attached information
(you will be allowed to upload files on the next page)

Conduct efficacy studies to add new disease, insect, or weed to the label

Conduct crop safety studies to add new crop to the label

Conduct plant growth regulator efficacy studies

3. Environmental (Ornamental) Horticulture Crop(s):

Plant Group:	Required
Common Name:	Required
Scientific Name:	Required
Plant Stage during Applications:	Required
Use Site:	Required
	(i.e. greenhouse, nursery field, nursery container, interiorscape, etc.)

4. Product:

Trade Name:	Required
Active Ingredient:	Required
Rate Per Application: (i.e. oz/100 gal, oz/acre)	Required
Volume Per Application: (i.e. gal/acre, pt/sq ft)	Required
Number of Applications:	Required
Application Interval:

5. Research Target/Registration Objective:

Phytotoxicity on crop(s) listed above

      Efficacy on this disease, insect, or weed:

             (Crop Safety information is also collected during these studies)

Plant Growth Regulator effects on crops listed above

6. Economic Impact:
Please estimate the economic impact in your state if the management tool described above is not available:

7. Labelled Products For This Use:

8. Additional Comments Or Explanation Of Need:



IMPORTANT: The more information we receive on these forms, the better we can address your needs!