Non-Member (landowner) Opt-Out Form

Non Member (Landowner) Herbicide Application Opt-Out Form

Please note that this form is valid for the calendar year. You will need to complete a new form each year.

Date(Required)

Did you receive notification from NHEC regarding the herbicide application program?(Required)
Name(Required)
Property Location(Required)
Mailing Address (if different from property location)(Required)
Consent(Required)