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Pest control forms

Pest control operator application forms

The department issues 3 types of pest control licence:

  • technician
  • trainee
  • interstate operator.

See Pest control licence applications for more information on each.

Application for a pest control licence - Technician
Word 146.98 KB
(opens in a new window)
Application for a pest control licence - Technician (PDF)
PDF 196.43 KB
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Application for a pest control licence - Trainee - Word template
Word 147.25 KB
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Application for a pest control licence - Trainee (PDF)
PDF 192.12 KB
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Application for a pest control licence - Interstate Operator
PDF 258.92 KB
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Application for a pest control licence - Interstate Operator
Word 150.36 KB
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Trainee skills declaration forms

The trainee must demonstrate the safe application of pesticides for the control of a particular pest, on a minimum of four separate occasions, for example:

  • Four independent applications of pesticides for the control of termites
  • Four independent applications of pesticides for the control of ants
  • Four independent applications of pesticides for the control of spiders

These applications must take place under the direct supervision of a licensed technician.

The supervisor must complete this declaration, by ticking that the trainee has addressed the relevant skill areas during each pest control job, then signing the form.

The form must then be returned to the Department indicating the trainee has the skills to safely apply pesticides to control a nominated pest under indirect supervision.

This form is to be used for one type of pest only. Additional forms need to be completed for other types of pest.

Trainee skills declaration for pest control work, excluding fumigation
Word 143.21 KB
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Trainee skills declaration for fumigation
Word 138.37 KB
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An example of how to fill out a trainee skills declaration form for pest control.

Trainee skills declaration - pest control example
PDF 136.3 KB
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Pest control licence refunds

Pest control licence refund policy

In order to obtain a refund, you must make an application to the department. You may do this by completing the refund application form. You are required to provide proof of any payment(s) in support of your application.

Pest control licence refund policy - December 2024
Word 133.79 KB
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For a refund of pest control licence fee, use the online application form(opens in a new window).

Pest control risk assessment forms

Health risk assessment template

Use this template for pesticide risk assessments.

Pesticide health risk assessment form
Word 110.9 KB
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Risk assessment template
PDF 127.81 KB
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Job site risk analysis checklist

A template for a job site risk analysis checklist.

Job site risk analysis checklist
Word 75 KB
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Job site risk analysis checklist
PDF 34.56 KB
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Pest control – other forms

Pest control licensing in Victoria - change of contact details

PCOs should use this form to notify the department of any change in contact details.

Pest control licensing in Victoria - change of contact details
Word 137.21 KB
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Pesticide Application Record Sheet

Pesticide application record sheet for pest control trader and operator. See record keeping for pest controllers page for more information.

Pesticide Application Record Sheet (PDF)
PDF 149.46 KB
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Pesticide Application Record Sheet (Word)
Word 51.11 KB
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Statutory Declaration for the state of Victoria

Use this template to create a statutory declaration for the state of Victoria.

Statutory Declaration for the state of Victoria
PDF 13.04 KB
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Updated