School Integrated Pest Management (IPM) Awards 

Application Guide 

Contents 

Explanation of the Five IPM Awards .................................................................................................................... 2 

Level 1- Great Start................................................................................................................................................... 2 

Level 2 - Leadership ................................................................................................................................................. 2 

Level 3 - Excellence ................................................................................................................................................. 2 

Level 4 – Sustained Excellence .......................................................................................................................... 2 

Level 5 - Champion .................................................................................................................................................... 2 

Application Timeline .................................................................................................................................................... 2 

Important Notes .............................................................................................................................................................. 2 

Compliance with State Laws ............................................................................................................................... 2 

Large School Districts ............................................................................................................................................. 3 

Sanitation, Exclusion, and Record-Keeping ................................................................................................ 3 

Criteria for Levels 1-3: Great Start, Leadership, and Excellence Awards ...................................... 4 

Criteria for Levels 4-5: Sustained Excellence and Champion Awards .............................................. 5 

Definitions and Clarification of Terms ................................................................................................................ 5 

Organizational Support ........................................................................................................................................... 5 

Written Documents ................................................................................................................................................... 6 

Education ....................................................................................................................................................................... 6 

Assessment ................................................................................................................................................................... 7 

Record-keeping ........................................................................................................................................................... 7 

Pesticide Safety .......................................................................................................................................................... 8 

Sanitation ....................................................................................................................................................................... 9 

Exclusion ...................................................................................................................................................................... 10 

Grounds/Outdoor....................................................................................................................................................... 10 
Explanation of the Five IPM Awards 

The US Environmental Protection Agency wishes to acknowledge school districts and individuals that 

protect students and the school community as a whole from pests and pesticides through the adoption of 

Integrated Pest Management (IPM). In order to recognize and reward these school districts and 

individuals, the EPA has established five IPM awards. 

Level 1: Great Start Award- Given to school districts that have demonstrated a commitment to 

implementing IPM 

[insert link to Great Start application] 

Level 2: Leadership Award- Given to school districts that have taken action to reduce the dangers 

associated with pests and pesticide use by implementing IPM 

[insert link to Leadership application] 

Level 3: Excellence Award- Given to school districts that have implemented exemplary IPM programs 

[insert link to Excellence application] 

Level 4: Sustained Excellence Award- Given to school districts that have been given the Excellence 

Award in the past and that have demonstrated the continued success and sustainability of their IPM 

programs 

[insert link to Sustained Excellence application] 

Level 5: Champion Award- Given to individuals and organizations that have contributed to the 

adoption and use of IPM policies in school districts at the community, state, region, or national level. 

[insert link to Change Agent application] 

Application Timeline 

Districts may apply for recognition at Levels 1 and 2 on a year-round basis. Applications for Levels 3-5 

should be submitted by November 1st. Awardees will be chosen by the following January. A district or 

individual may apply as many times as they would like for the awards. A district may be given any of the 

awards multiple times, with the exception of the Excellence Award. A district may receive the Excellence 

Award only once. 

Important Notes 

Compliance with State Laws 

In order for a district to be eligible to receive an IPM award from the EPA, that district must be in 

compliance with state laws, including those regarding pest management. Some states have laws which are 

more stringent than the guidelines provided in this document. Districts in states with laws which are more 
stringent than the guidelines in this document must still adhere to state law in order to be eligible to receive 

an IPM award from the US EPA. 

Large School Districts 

The EPA recognizes that implementation of an IPM program may be especially difficult for large school 

districts. When reviewing a district’s IPM award application, the EPA will consider the number of students 

and facilities in that district. Large districts which have IPM pilot programs at one or several facilities may 

receive awards. Large school districts with pilot programs should explain in their applications the number 

of facilities in which the pilot program is being implemented. 

Sanitation, Exclusion, and Record-Keeping are important at all stages of an IPM program 

While the criteria for the Great Start Award do not include sanitation, exclusion, or record-keeping 

requirements, the EPA is not implying that these aspects of IPM are not important. In fact, good 

sanitation, sealing of holes and cracks in buildings, and record-keeping can have benefits that extend 

beyond IPM, such as lower energy bills and more effective use of staff time. 
Criteria for Great Start, Leadership, and Excellence Awards 

In order to receive recognition at level 2 or 3, a district must fulfill all of the criteria for that award as well 

as the criteria for all lower-level awards. 

 Level 1: Great Start Level 2: Leadership Level 3: Excellence 

Laws 

Must meet all 

applicable state or 

tribal laws 

Must meet all 

applicable state or 

tribal laws 

Must meet all applicable state or tribal 

laws

Previous 

Recognition / 

Miscellaneous 

School districts with existing 

third-party certification may qualify 

and/or credit may be given for other 

IPM activities. 

(at discretion of reviewer) 

Organizational 

Support IPM Coordinator

Environmental 

Health / IPM 

Committee

The pest management professional and 

the school administration are informed 

of the decisions and actions of the IPM 

Committee. The committee and the 

pest management professional follow 

the IPM Plan proactively. 

Written Statements Written IPM policy

Written IPM plan 

including pest 

thresholds IPM plan is updated annually 

Education 

Coordinator receives 

IPM education

IPM education for 

custodial, 

maintenance, 

groundskeeper, 

kitchen, and nurse 

staff 

IPM education for staff, including 

teachers and coaches, with certificates 

awarded 

Assessment 

Self-assessment 

using checklist

Monthly inspection

of pest vulnerable 

areas (including 

insect and rodent 

stations) Full inspection all facilities (Annually) 

Record-keeping 

Pesticide use 

records, 

monitoring records

Maintenance records, 

pest sighting/complaint records

Pesticide Safety Certified applicator

Warning signs / 

notification, 

correct storage, 

Follow guidelines for 

pesticide selection and application 

Sanitation 

Trash areas well 

maintained, 

dumpster distance

Appropriate food storage, 

kitchen sanitation, rooms free of 

clutter

Exclusion Door sweeps

Structure free of gaps, holes, 

and other entry points

Grounds/Outdoor 

Visibility between 

landscaping and 

facility

Exterior free of clutter and 

harborage
Criteria for Level 4: Sustained Excellence Award 

To qualify for Level 4 recognition, a district must: 

≠ demonstrate that it continues to meet all Level 3 criteria for at least two years after receiving Level 3 

recognition. 

≠ provide documentation of its strategy and efforts to make its IPM program sustainable. 

≠ provide documentation of program results in terms of pest reduction, health improvements, and 

financial benefits. Note that this does not mean the district must meet some quantified level of 

results – this is more about making sure that the district is documenting its program’s results than 

making sure the programs are achieving some set level of success. 

≠ demonstrate how it has been communicating about its IPM program, both to its internal 

community (students, parents, employees) and to the external community (other districts, 

educational associations). 

As many third-party certifications require recertification, repeated recognition can provide evidence that a 

district continues to meet all Level 3 criteria. However, districts that receive repeated third-party 

recognition must also meet the other Level 4 criteria (demonstrating sustainability, results, and 

communication). 

Criteria for Level 5*: Champion Award 

Level 5 is an award for individuals and organizations that have contributed to the adoption and use of IPM 

policies in school districts at the community, state, region, or national level. 

Level 5 awardees must: 

≠ demonstrate actions and initiatives that support school IPM. 

≠ provide a detailed account of their actions contributing to school IPM, including documentation of 

the results of their actions (what these results would be depends on the specific actions taken). 

≠ describe how they communicated with school districts (if working at higher or lower levels, this 

could instead be state boards of education or individual schools) to facilitate their IPM efforts. 

≠ demonstrate how the achievements made by their actions will be sustained in the future. 

≠ have at least one endorsement from a relevant entity (school, school district, state board, etc.) in 

order to verify the significance of their contribution. 

Definitions and Clarification of Terms 

Organizational Support 

IPM Coordinator 

There must be someone at the facility who coordinates pest control activities. This person might: 

1) Interact with a pest control professional before, during or after their visit 

2) Keep records of complaints, monitoring and applications 

3) Be familiar with pest threats and pressures; as well as PVAs of the facility 

4) Decide when and where pesticides will be applied 

It doesn’t matter what exactly their role in pest management is, but rather that there is someone in-house 

who is taking or wants to take ownership of the facility’s pest management program. 
IPM Committee or Environmental Health Committee 

This group should be made up of the IPM coordinator, the school nurse, and at least one person from 

each of the following groups: teachers, custodial/maintenance staff, students, and parents. The 

committee’s responsibilities include providing guidance, education, and support on program procedures 

and processes. The district leadership will appoint the members of this committee. The committee should 

meet at least semi-annually. 

Written Documents 

IPM Policy 

This written document includes the following components: 

1) Prevention (sanitation, exclusion, routine inspections, etc.) 

2) Regular monitoring 

3) Preference for least-risk pesticides and application methods 

4) Record keeping (monitoring, applications, work orders, etc.) 

5) Pesticides used only when needed (someone makes a calculated decision to apply or not) 

6) Protecting children or reducing health hazards associated with pests and pesticides 

A sample IPM Policy can be found at [insert link]. 

IPM Plan 

An IPM plan addresses and details the components of the district policy, lists approved low 

hazard/toxicity products and methods by pest, and discusses the decision-making process for any pest 

mitigation effort, to include methods for monitoring, reporting pest sightings, action levels for the use of 

pesticides and a list of all environmentally sensitive areas that may be impacted by the district’s pest 

management activities. The IPM coordinator develops and submits a recommended pesticide safety and 

IPM plan to the IPM committee for review and comment. The IPM coordinator submits a final draft, 

which addresses committee comments, to the district leadership for submission to the board. Pests are 

listed in order of medical or health risk importance to assist in prioritizing pest mitigation efforts based on 

risk to students, staff and the community. The IPM coordinator, in coordination with the designated 

district school nurse, develops and includes appropriate action steps in the program plan for each pest of 

public health importance deemed a probable risk by the committee (head lice, bed bugs, fire ants, etc.). A 

sample IPM Plan can be found at [insert link]. 

Difference between Policy and Plan 

An IPM Policy sets out a district’s IPM goals and requirements; an IPM Plan determines actions that 

ensure that the goals and requirements set out in the policy will be met. 

Education 

≠ The IPM coordinator should be trained in the principles of Integrated Pest Management and pest 

control contract oversight, completing a minimum of six (6) to eight (8) contact hours of training 

annually on the subject. 

≠ Custodial and food service staff should be trained a minimum of one (1) hour annually on the 

components of IPM and how their efforts towards sanitation impact pest infestations. 

≠ Facilities management personnel should be trained a minimum of one (1) hour annually on the 

components of IPM and how their efforts at sealing the building envelope and repairing water leaks 

impact pest infestations. 
≠ Teachers and administrative staff should be trained a minimum of one (1) hour annually on the 

components of IPM and how their efforts for clutter removal and general classroom/office 

sanitation impact pest infestations. 

≠ Students and the general public should be provided direct and supplemental education/information 

on the district’s program, and how they contribute to success of the program. 

≠ All personnel should be trained on how to identify and report pest problems and conditions that 

lead to pest infestations. 

Assessment 

Checklist 

The IPM coordinator walks through the district’s facilities and fills out an IPM self-assessment checklist. A 

self-assessment checklist can be found at [insert link]. 

Routine inspections 

The purpose of routine inspections is to prevent new infestations, identify emerging ones, and evaluate 

current pest management practices. A trained staff or professional should be looking for pest evidence, 

access points, sources of food and water, harborage sites, and pest populations at least monthly in pest 

vulnerable areas, such as: kitchens, food storage areas, cafeterias, custodial closets, teachers’ lounge, 

exterior areas, and dumpster areas.i

 Routine visits from a pest control company may or may not include 

this type of proactive inspection. Reporting that, “yes, they are done by the pest guy”, is not sufficient. 

Replacing baits or traps is not considered “routine inspections” in this instance. Checking monitoring 

stations, assessing pest-conducive conditions and identifying emerging problems would be considered 

“routine inspections.” 

Insect or rodent stations 

Monitoring stations or traps should be in kitchens, food storage areas, cafeterias, custodial closets, and 

other PVAs. Monitoring stations may include insect sticky traps, rodent traps or nontoxic detection 

blocks. The facility must have signs of an active monitoring program (traps in PVAs) and a log of 

findings.ii Ensure that monitor traps have dates and that the pests observed in the traps are properly 

identified and that records are kept of where monitor stations are placed. Traps and monitoring stations 

should be inaccessible to children. 

Full Inspection 

Districts should do a thorough inspection of facilities for evidence of pests, pest-conducive conditions, and 

pesticide danger (improper storage, improper labeling, etc.) annually. The inspection should be performed 

by the IPM Coordinator, accompanied by another member of the IPM committee. If the district has 

contracted any pest management services to an outside company, the outside pest manager should 

accompany the IPM Coordinator during the inspection. It is ideal, however, that thorough inspections be 

conducted quarterly because each season of the year can present unique pest issues. 

Record-keeping 

Pesticide use records 

Pesticide use records need to include all the following: 

-Name of applicator 

-Pesticide used with EPA registration number, label rate and amount applied (with copy 

 of label)iii
 -Targeted pest 

 -Location treated 

 -Date and time of application 

 -Application method 

States and tribes vary on how long records must be retained. Facilities should maintain records for at least 

a year, if not longer, in order to determine trends and identify problem areas. The IPM Institute of North 

America recommends retaining records for a minimum of three years.iv

Monitoring Records 

The findings from each monthly inspection should be recorded. The dates that traps and insect/rodent 

stations are placed and replaced should be recorded. 

Pest sighting or complaint logs in use 

A simple tracking device or system is in place for building occupants (staff, parents, teachers, students) to 

note where and when they see a pest.v Sometimes you may see these logs posted in bathrooms and other 

PVAs, other times you’ll need to ask directly whether there are logs in place. 

Maintenance Records 

The IPM coordinator or facility manager should keep records of all pest-related maintenance requests and 

maintenance operations. 

Pesticide Safety 

Posting 

Pesticide application sites are posted with highly visible signage during and at least 24- 

48 hours after all pesticide applications. Postings are labeled with the date of application, pest treated for, 

pesticide used, applicator name, certification number of applicator, phone number of applicator/company, 

and date/time reentry is authorized. For emergency applications where an imminent threat to health exists 

(e.g., stinging insects), postings must be placed as soon as practical, with a preference to no later than the 

start of the pesticide application. 

Notification 

Students, staff and parents/guardians are notified at least 24-48 hours prior to any pesticide application. 

For emergency applications where an imminent threat to health exists (e.g., stinging insects), students, staff, 

and parents/guardians will be notified within 24 hours after the pesticide application. 

Posting and Notification Exemption 

The use of insecticide or rodenticide baits in pre-manufactured, tamper-resistant containers placed in areas 

inaccessible to children, insecticide baits in gel or paste form placed in cracks and crevices inaccessible to 

children, and antimicrobial pesticides, including sanitizers and disinfectants, are exempt from notification, 

posting and exclusion requirements unless specified otherwise on label directions. Rodenticide baits in 

tamper-proof containers are exempt from exclusion requirements, but must be labeled with all other 

posting requirements on the exterior of each container. Such containers should be limited to areas 

normally inaccessible to children. 
Pesticides stored safely 

All pesticide products should be in a locked room or cabinet, away from food storage and preparation 

areas, and accessible only to authorized staff. All pesticide products should be stored in original containers 

with labels.vi

Certified Pesticide Applicators 

Only state or tribe certified pesticide applicators trained in Integrated Pest 

Management apply pesticides on School District properties. 

Guidelines for Pesticide Selection and Application 

When reasonable non-chemical approaches do not provide adequate control, products that pose the least 

risk to people and the environment are be selected, and then only used when and where pests are present, 

or expected to be present, as determined by monitoring and action thresholds and approved by the IPM 

coordinator. Pesticide applications are not made on a routine or regularly scheduled basis. The use of 

pesticides with the signal words ‘Warning’ and ‘Danger’ should be avoided. In documented emergency 

situations where the presence of a pest immediately threatens the health or safety of students, staff, faculty 

members or members of the public using the campus, the IPM coordinator may consider the use of 

pesticide products that do not fit the above criteria. 

Pesticides must not applied when persons, other than pesticide applicators, are present or 

are expected to be present. All persons other than the pesticide applicators must be excluded from the 

treated site for at least eight (8) hours after the completion of any pesticide application, or as prescribed by 

the pesticide label, whichever is longer. 

Sanitation 

Trash areas well maintained, clean and contained 

Trash cans and dumpsters should be in good condition (without holes), clean (without waste buildup) and 

have tight fitting lids (in use) to restrict pest access and attraction to garbage areas. Trash should not be 

flowing out or spilling over the container. The area around trash cans and dumpsters should also be cleanfree of waste and spills.vii

Dumpster(s) located 50 ft. from facility 

Dumpster(s) located at least 50 ft. from the facility attract pests away from the building, where they are less 

likely to cause damage and get indoors.viii

Appropriate food storage 

Refrigerators and freezers should be tightly sealed, clean and organized to mitigate pest access and 

attraction. Dried and canned foods should be removed from cardboard boxes and stored on shelves at 

least six inches off the ground.ix Cardboard boxes should be mostly broken down and recycled. Dry 

goods such as flour, sugar, beans, cereals, etc. should be stored in pest resistant containers with snap-tight 

or screw-top lids. All shelving should be made of non-absorbent material and easy to move for routine 

cleaning. 

Good sanitation in kitchen, cafeteria, and food storage areas 

Kitchens, cafeterias, other eating areas (offices, classrooms, concession stands) and food storage areas 

should be free of food crumbs, spills, grease buildup and other organic debris in and under appliances, 
equipment, corners, cabinets, and drains (floor and sink). All areas should be cleaned thoroughly, at least 

daily. 

Rooms free of food debris and/or clutter 

Non-food areas should be mostly free of food debris and clutter, including excess or unused equipment. 

Rooms that should be considered include classrooms, locker areas, storage areas, and lounge areas. Art 

supplies and food-related materials are in sealed clear containers to keep out pests. Storage cabinets are 

organized and searchable. Students’ lockers/cubby spaces are clean and monitored regularly for possible 

pests. 

Exclusion 

Door sweeps 

Door sweeps must be installed on exterior doors. The door sweeps must be have dense bristles and 

installed in such manner that no holes for pest entry are visible. 

Structure free of gaps, holes and other entry points 

The exterior of the facility should be mostly free entry points that allow pests access to the structure.x If 

you can see light through gaps and holes, there is enough space to allow arthropods (insects, arachnids and 

crustaceans) access; rodents require a larger space-anywhere between 1⁄4 to 1⁄2 inch, depending on the 

species.xi Entry points might include: gaps around doors, windows and wall penetrations (including 

unsealed gaps around utility entryways); cracks in the foundation and walls; missing or torn screens on 

vents, doors and windows; crawl space doors/entrances; gaps and missing panels around roof top vents 

and HVAC systems; roof eaves; and propped open doors. If you are unsure whether a space can provide 

access, use your pen or pencil to see if it can pass through. If so, a rodent, insect or spider could get in that 

way. 

Grounds/Outdoor 

Visibility between landscaping and facility 

The exterior of the facility should be mostly free of excessive, thick, brushy or weedy vegetation to increase 

visibility and to minimize pest attraction and access to structure. Vegetation including ivy, shrubs, and 

branches should not be in contact with the structure. There should also not be excessive soil, grass, mulch 

or stones next to the structure. Grass next to the building should not exceed a height of more than 12 

inches.xii You should be able to see the building foundation to inspect for pests. 

Exterior free of clutter and harborage 

The exterior of the facility should be mostly free of clutter and harborage.xiii Harborage is any condition 

that provides a shelter or breeding area for pests. Examples: wood piles, food debris and yard waste 

(leaves, rotting fruit, and branches), standing water, equipment stored outdoors including kitchen 

appliances, furniture, landscaping and maintenance tools, and construction materials. 

 

i

 Gouge, Baldwin, Oi, & Schmeits, IPM in Schools/Child Care Pest Monitoring Protocol, Apr 2007, 

http://www.extension.org/mediawiki/files/7/78/schoolipm_pest_monitoring_protocol_4.3.pdf

ii Gouge, Baldwin, Oi, & Schmeits, op. cit. 

iii Environmental Protection Agency, Pest Control in the School Environment: Adopting Integrated Pest Management, Aug 

1993, http://www.epa.gov/pesticides/ipm/brochure/EPA-735-F-93-012.pdf

iv IPM Institute of North America, IPM Standards, op. cit. 

 
 v IPM Institute of North America, School IPM 2015: A Strategic Plan for Integrated Pest Management in Schools in the 

United States, July 11, 2011 

http://www.ipminstitute.org/school_ipm_2015/SCHOOL_IPM_2015_v2%200_DRAFT_FOR_COMMENT_071111

.pdf vi eXtension’s “School IPM Pesticide Storage Tips”, Feb 2014, http://www.extension.org/pages/20396/school-ipmpesticide-storage-tips

vii IPM Institute of North America’s “IPM Standards for Schools,” July 2004. 

http://www.ipminstitute.org/pdf/ISS%20V3.2%20073004.pdf viii Merchant, Swiger, PMSP, Extension.org, School IPM Action Plan for House Flies and Filth Flies, May 2012, 

http://www.extension.org/pages/63910/school-ipm-action-plan-for-house-flies-and-filth-flies; Gouge, Lame, Glick, 

CA Dept of Pesticide Regulation, Integrated Pest Managment- Design Considerations for Schools, 2009, 

http://apps.cdpr.ca.gov/schoolipm/architects_designers/architectural_guide.pdf; ix Iowa State Univ, Food Safety Project, https://www.extension.iastate.edu/NR/rdonlyres/071E9D9B-390B-4DDB9CDD-34B9105C0E06/63234/SCSOP13PestControl.doc; WSU School IPM “What is IPM?,” 2014, 

http://schoolipm.wsu.edu/what.html 

x 21 CFR 110.20 & 21 CFR 110.35, “The plant and facilities shall provide, where necessary, adequate screening or other 

protection against pests. Buildings, fixtures, and other physical facilities of the plant shall be maintained in a sanitary condition 

and shall be kept in repair sufficient to prevent food from becoming adulterated within the meaning of the act. Effective 

measures shall be taken to exclude pests from the processing areas and to protect against the contamination of food on the 

premises by pests. “ 

xi Geiger & Cox, SF Environment, Pest Prevention by Design, Nov 2012, 

http://www.sfenvironment.org/download/pest-prevention-by-design-guidelines; Green, Graham, & Hurley, 

Extension.org Pest Proofing and Exclusion Webinar, Sept 2012, https://learn.extension.org/events/587; Stock, Corrigan, 

Gouge, Oregon State University, Integrated Pest Management of the House Mouse, Apr 2013, 

http://ir.library.oregonstate.edu/xmlui/bitstream/handle/1957/38106/em9062.pdf; W.H. Kern, Jr. and P.G. Koehler, 

University of Florida, Mar 1998, http://schoolipm.ifas.ufl.edu/tp9.htm xii Centers for Disease Control and Prevention. "Integrated pest management: conducting urban rodent surveys. Atlanta: US 

Department of Health and Human Services; 2006, http://www.cdc.gov/nceh/ehs/docs/ipm_manual.pdf xiii 21 CFR 110.20 & 21 CFR 110.35, “The grounds under the control of the operator shall be kept in a condition that will 

protect against the contamination of food. Adequate maintenance of the grounds include, but not limited to: properly storing 

equipment, removing litter and waste, and cutting weeds or grass within the immediate vicinity of the plant buildings or 

structures that may constitute an attractant, breeding place, or harborage for pests; and adequately draining areas that may 

contribute contamination to food by seepage, foot-borne filth, or providing a breeding place for pests.”; University of Florida 

Extension, Florida School IPM Best Management Practices, Aug 2012, 

http://schoolipm.ifas.ufl.edu/Florida/Floridaipmbmp2012.pdf
Dear Katy ISD: 

The U.S. Environmental Protection Agency (EPA) is developing a tiered awards program 

to recognize school districts across the country that are working towards, or have 

achieved, a level of success with their School Integrated Pest Management (IPM) 

programs. 

Before launching the awards program, EPA must meet the requirements of the Paperwork 

Reduction Act. One of these requirements is the completion of an Information Collection 

Request (ICR). Part of the ICR process requires the Agency to report the time it takes 

school districts to complete the award application. The outcome of this process is called a 

paperwork burden estimate. 

We have identified your district as a potential participant in our awards program. We are 

requesting your assistance in creating a paperwork burden estimate. We will be working 

with several districts to get their burden estimates for one of the five award tiers being 

developed. Your district is asked to provide a burden estimate for the Leadership award. 

What we are Asking You to Do: 

Using the attached Leadership award application form, record the time spent on 

paperwork in the table below along with the job title of the person(s) performing those 

activities. For example, for the third activity category (Gather information), record the 

types of tasks performed in this category, the job title(s) and number of employees 

performing this task, and the average number of hours spent by each employee on the 

task. An example of how to record the information is provided below. 
Respondent 

Paperwork Activity 

Category

Description of Category 

(Specific task performed)

Job Title and Number of 

Employees Performing this 

Task

Average Time (in hours) 

Spent by Each Employee

on this Task

Example: Gather 

information

Request information from 

schools IPM Coordinator, 1 1.5

Example: Gather 

information

Gather requested information 

and submit to district Administrative assistant, 4 5.0

1. Read instructions Read Application Guide and 

application for relevant Tier. Environmental Manager 1 hour

2. Plan activities Plan gathering of information 

that will be submitted to EPA. Environmental Manager 1.5 hour

3. Gather 

information

Canvass / Contact personnel 

from schools within the 

district to gather information 

for application. 

Environmental Manager 5 hours per campus

4. Compile and 

review

Assemble data, evaluate for 

accuracy, appropriateness, 

and completeness. 

Environmental Manager 5 hours plus 1 hour per 

campus

5. Complete and 

submit paperwork

Complete all appropriate 

application documents and 

send to EPA. 

Environmental Manager 5 hours plus 1 per 

campus

6. Store/Maintain 

data

File and maintain copies of 

materials submitted to EPA. Environmental Manager 2 hours

Please return your responses to Tom Cook at cook.tom@epa.gov.

Our Timeline: 

Please provide the requested information within 7 days of receipt. 

Goal of the EPA’s School IPM Awards Program: 

EPA’s incentive-based awards program will recognize schools for implementing IPM. 

The program will take into account the unique challenges of each district when providing 

them with educational and recognition opportunities. There will be five categories of 

awards to represent the level of effort and success that each district achieves. 

What is IPM? 

Integrated Pest Management (IPM) is a sustainable approach to managing pests by 

combining biological, cultural, physical, and chemical tools in a way that minimizes 

economic, health, and environmental risks. Implementing a School IPM program creates 

a safer and healthier learning environment by helping to manage pests while reducing 

pesticide use, pest complaints, and children’s exposure to pesticides. 
EPA School IPM Awards 

Great Start Award 

The School IPM Great Start Award is presented to school districts that are in the 

initial stages of implementing effective IPM programs. Schools can qualify for this 

award by selecting an IPM Coordinator and creating a written IPM Policy. 

Leadership Award 

The School IPM Leadership Award is presented to schools and/or school districts 

with a senior-level commitment to establishing and maintaining sustainable IPM 

programs and relate IPM strategies to the framework for effective school IPM 

programs (i.e., Organize, Assess, Plan, Act, Evaluate, and Communicate). 

Excellence Award 

To merit the School IPM National Excellence Award, an applicant will tell the story 

of their IPM program in a way that demonstrates their program is comprehensive, 

effective, and moving towards being institutionalized as part of a comprehensive 

environmental health program. Specifically, EPA will look for evidence that: 

 the critical components that lead to program effectiveness (i.e., the Six Key 

Drivers of School IPM Program Success) are embodied in the school 

environmental health management program; 

 an established system exists to ensure consistent and sustained action to 

identify, address and prevent pest problems; and 

 the program is achieving results. 

Model of Sustained Excellence Award 

To merit a School IPM Model of Sustained Excellence Award, an applicant will tell 

the story of their IPM program in a way that demonstrates that the program is 

comprehensive, effective, and sustained and institutionalized as part of a 

comprehensive environmental health program. Specifically, EPA will require that

they: 

 have previously won the School IPM Excellence Award which shows that 

they have successfully implemented and sustained an effective IPM program; 

 have established long-term school IPM goals; 

 are tracking the results of their program; and 

 are utilizing district-wide communication and school IPM policies. 

Connector Award 

The School IPM Connector Award is designed to give national recognition to 

individuals and organizations whose actions improved school environmental health in 

their community, region, state, or the nation, with a special focus the connective spirit 

of the award. Examples include: 

 Development of innovative initiatives, approaches, tools, or resources that 

have contributed to improved school IPM and indoor environments; 
 Outstanding individuals and groups who have played a coordinating function 

to bring people or IPM programs together to provide mutual assistance and 

support for school IPM implementation; 

 Leadership/Mentorship of school or school district IPM programs; 

 Technical assistance in IPM implementation; 

 Increasing student involvement in IPM, such as integration of science clubs; 

and 

 Other actions and initiatives that foster interconnectedness and mutual support 

with demonstrated results.

For Questions and Assistance

Please contact Thomas Cook at cook.tom@epa.gov or 214-665-9731. 

We appreciate your willingness to work with us in developing our School IPM Awards 

program. We are grateful for the time you spent in developing your burden estimate to 

complete the award application. 

Sincerely, 

Thomas Cook, Lead 

Center of Expertise for School IPM 

Office of Pesticide Programs 
Dear Livermore Valley Joint Unified School District: 

The U.S. Environmental Protection Agency (EPA) is developing a tiered awards program 

to recognize school districts across the country that are working towards, or have 

achieved, a level of success with their School Integrated Pest Management (IPM) 

programs. 

Before launching the awards program, EPA must meet the requirements of the Paperwork 

Reduction Act. One of these requirements is the completion of an Information Collection 

Request (ICR). Part of the ICR process requires the Agency to report the time it takes 

school districts to complete the award application. The outcome of this process is called a 

paperwork burden estimate. 

We have identified your district as a potential participant in our awards program. We are 

requesting your assistance in creating a paperwork burden estimate. We will be working 

with several districts to get their burden estimates for one of the five award tiers being 

developed. Your district is asked to provide a burden estimate for the Great Start award. 

What we are Asking You to Do: 

Using the attached Great Start award application form, record the time spent on 

paperwork in the table below along with the job title of the person(s) performing those 

activities. For example, for the third activity category (Gather information), record the 

types of tasks performed in this category, the job title(s) and number of employees 

performing this task, and the average number of hours spent by each employee on the 

task. An example of how to record the information is provided below. 
Respondent 

Paperwork Activity 

Category

Description of Category 

(Specific task performed)

Job Title and Number of 

Employees Performing this 

Task

Average Time (in hours) 

Spent by Each Employee

on this Task

Example: Gather 

information

Request information from 

schools IPM Coordinator, 1 1.5

Example: Gather 

information

Gather requested information 

and submit to district Administrative assistant, 4 5.0

1. Read instructions Read Application Guide and 

application for relevant Tier. Environmental Manager 10 minutes 

2. Plan activities Plan gathering of information 

that will be submitted to EPA. Environmental Manager 30 minutes 

3. Gather 

information

Canvass / Contact personnel 

from schools within the 

district to gather information 

for application. 

Environmental Manager 1 hour 

4. Compile and 

review

Assemble data, evaluate for 

accuracy, appropriateness, 

and completeness. 

Environmental Manager 1 hour 

5. Complete and 

submit paperwork

Complete all appropriate 

application documents and 

send to EPA. 

Environmental Manager 45 minutes 

6. Store/Maintain 

data

File and maintain copies of 

materials submitted to EPA. Environmental Manager 15 minutes 

Please return your responses to Tom Cook at cook.tom@epa.gov.

Our Timeline: 

Please provide the requested information within 30 days of receipt. 

Goal of the EPA’s School IPM Awards Program: 

EPA’s incentive-based awards program will recognize schools for implementing IPM. 

The program will take into account the unique challenges of each district when providing 

them with educational and recognition opportunities. There will be five categories of 

awards to represent the level of effort and success that each district achieves. 

What is IPM? 

Integrated Pest Management (IPM) is a sustainable approach to managing pests by 

combining biological, cultural, physical, and chemical tools in a way that minimizes 

economic, health, and environmental risks. Implementing a School IPM program creates 

a safer and healthier learning environment by helping to manage pests while reducing 

pesticide use, pest complaints, and children’s exposure to pesticides. 
EPA School IPM Awards 

Great Start Award 

The School IPM Great Start Award is presented to school districts that are in the 

initial stages of implementing effective IPM programs. Schools can qualify for this 

award by selecting an IPM Coordinator and creating a written IPM Policy. 

Leadership Award 

The School IPM Leadership Award is presented to schools and/or school districts 

with a senior-level commitment to establishing and maintaining sustainable IPM 

programs and relate IPM strategies to the framework for effective school IPM 

programs (i.e., Organize, Assess, Plan, Act, Evaluate, and Communicate). 

Excellence Award 

To merit the School IPM National Excellence Award, an applicant will tell the story 

of their IPM program in a way that demonstrates their program is comprehensive, 

effective, and moving towards being institutionalized as part of a comprehensive 

environmental health program. Specifically, EPA will look for evidence that: 

 the critical components that lead to program effectiveness (i.e., the Six Key 

Drivers of School IPM Program Success) are embodied in the school 

environmental health management program; 

 an established system exists to ensure consistent and sustained action to 

identify, address and prevent pest problems; and 

 the program is achieving results. 

Model of Sustained Excellence Award 

To merit a School IPM Model of Sustained Excellence Award, an applicant will tell 

the story of their IPM program in a way that demonstrates that the program is 

comprehensive, effective, and sustained and institutionalized as part of a 

comprehensive environmental health program. Specifically, EPA will require that

they: 

 have previously won the School IPM Excellence Award which shows that 

they have successfully implemented and sustained an effective IPM program; 

 have established long-term school IPM goals; 

 are tracking the results of their program; and 

 are utilizing district-wide communication and school IPM policies. 

Connector Award 

The School IPM Connector Award is designed to give national recognition to 

individuals and organizations whose actions improved school environmental health in 

their community, region, state, or the nation, with a special focus the connective spirit 

of the award. Examples include: 

 Development of innovative initiatives, approaches, tools, or resources that 

have contributed to improved school IPM and indoor environments; 
 Outstanding individuals and groups who have played a coordinating function 

to bring people or IPM programs together to provide mutual assistance and 

support for school IPM implementation; 

 Leadership/Mentorship of school or school district IPM programs; 

 Technical assistance in IPM implementation; 

 Increasing student involvement in IPM, such as integration of science clubs; 

and 

 Other actions and initiatives that foster interconnectedness and mutual support 

with demonstrated results.

For Questions and Assistance

Please contact Thomas Cook at cook.tom@epa.gov or 214-665-9731. 

We appreciate your willingness to work with us in developing our School IPM Awards 

program. We are grateful for the time you spent in developing your burden estimate to 

complete the award application. 

Sincerely, 

Thomas Cook, Lead 

Center of Expertise for School IPM 

Office of Pesticide Programs 
Dear Metro Tech High School: 

The U.S. Environmental Protection Agency (EPA) is developing a tiered awards program 

to recognize school districts across the country that are working towards, or have 

achieved, a level of success with their School Integrated Pest Management (IPM) 

programs. 

Before launching the awards program, EPA must meet the requirements of the Paperwork 

Reduction Act. One of these requirements is the completion of an Information Collection 

Request (ICR). Part of the ICR process requires the Agency to report the time it takes 

school districts to complete the award application. The outcome of this process is called a 

paperwork burden estimate. 

We have identified your district as a potential participant in our awards program. We are 

requesting your assistance in creating a paperwork burden estimate. We will be working 

with several districts to get their burden estimates for one of the five award tiers being 

developed. Your district is asked to provide a burden estimate for the Excellence award. 

What we are Asking You to Do: 

Using the attached Excellence award application form, record the time spent on 

paperwork in the table below along with the job title of the person(s) performing those 

activities. For example, for the third activity category (Gather information), record the 

types of tasks performed in this category, the job title(s) and number of employees 

performing this task, and the average number of hours spent by each employee on the 

task. An example of how to record the information is provided below. 
Respondent 

Paperwork Activity 

Category

Description of Category 

(Specific task performed)

Job Title and Number of 

Employees Performing this 

Task

Average Time (in hours) 

Spent by Each Employee

on this Task

Example: Gather 

information

Request information from 

schools IPM Coordinator, 1 1.5

Example: Gather 

information

Gather requested information 

and submit to district Administrative assistant, 4 5.0

1. Read instructions Read Application Guide and 

application for relevant Tier.

IPM Coordinator, Safety 

Coordinator, or Quality 

Assurance Specialist

0.5 hours 

2. Plan activities Plan gathering of information 

that will be submitted to EPA.

IPM Coordinator, Safety 

Coordinator, or Quality 

Assurance Specialist, food 

service personnel, certified

pest technician, school nurse 

4 hours 

3. Gather 

information

Canvass / Contact personnel 

from schools within the 

district to gather information 

for application. 

IPM Coordinator, Safety 

Coordinator, or Quality 

Assurance Specialist, food 

service personnel, certified

pest technician, school nurse , 

Campus Facility Supervisors, 

Custodians and 

Groundskeepers

16 hours

4. Compile and 

review

Assemble data, evaluate for 

accuracy, appropriateness, 

and completeness. 

IPM Coordinator, Quality 

Assurance Specialist, Director

of Facilities and Asst

Superintendent of Operations

2- 4 hours

5. Complete and 

submit paperwork

Complete all appropriate 

application documents and 

send to EPA. 

IPM Coordinator and or 

Quality Assurance Specialist 2-4 hours

6. Store/Maintain 

data

File and maintain copies of 

materials submitted to EPA.

IPM Coordinator or Quality 

Assurance Specialist or Admin 

Asst

1 hour

Please return your responses to Tom Cook at cook.tom@epa.gov.

Our Timeline: 

Please provide the requested information within 7 days of receipt. 

Goal of the EPA’s School IPM Awards Program: 

EPA’s incentive-based awards program will recognize schools for implementing IPM. 

The program will take into account the unique challenges of each district when providing 

them with educational and recognition opportunities. There will be five categories of 

awards to represent the level of effort and success that each district achieves. 

What is IPM? 

Integrated Pest Management (IPM) is a sustainable approach to managing pests by 
combining biological, cultural, physical, and chemical tools in a way that minimizes 

economic, health, and environmental risks. Implementing a School IPM program creates 

a safer and healthier learning environment by helping to manage pests while reducing 

pesticide use, pest complaints, and children’s exposure to pesticides. 

EPA School IPM Awards 

Great Start Award 

The School IPM Great Start Award is presented to school districts that are in the 

initial stages of implementing effective IPM programs. Schools can qualify for this 

award by selecting an IPM Coordinator and creating a written IPM Policy. 

Leadership Award 

The School IPM Leadership Award is presented to schools and/or school districts 

with a senior-level commitment to establishing and maintaining sustainable IPM 

programs and relate IPM strategies to the framework for effective school IPM 

programs (i.e., Organize, Assess, Plan, Act, Evaluate, and Communicate). 

Excellence Award 

To merit the School IPM National Excellence Award, an applicant will tell the story 

of their IPM program in a way that demonstrates their program is comprehensive, 

effective, and moving towards being institutionalized as part of a comprehensive 

environmental health program. Specifically, EPA will look for evidence that: 

 the critical components that lead to program effectiveness (i.e., the Six Key 

Drivers of School IPM Program Success) are embodied in the school 

environmental health management program; 

 an established system exists to ensure consistent and sustained action to 

identify, address and prevent pest problems; and 

 the program is achieving results. 

Model of Sustained Excellence Award 

To merit a School IPM Model of Sustained Excellence Award, an applicant will tell 

the story of their IPM program in a way that demonstrates that the program is 

comprehensive, effective, and sustained and institutionalized as part of a 

comprehensive environmental health program. Specifically, EPA will require that

they: 

 have previously won the School IPM Excellence Award which shows that 

they have successfully implemented and sustained an effective IPM program; 

 have established long-term school IPM goals; 

 are tracking the results of their program; and 

 are utilizing district-wide communication and school IPM policies. 
Connector Award 

The School IPM Connector Award is designed to give national recognition to 

individuals and organizations whose actions improved school environmental health in 

their community, region, state, or the nation, with a special focus the connective spirit 

of the award. Examples include: 

 Development of innovative initiatives, approaches, tools, or resources that 

have contributed to improved school IPM and indoor environments; 

 Outstanding individuals and groups who have played a coordinating function 

to bring people or IPM programs together to provide mutual assistance and 

support for school IPM implementation; 

 Leadership/Mentorship of school or school district IPM programs; 

 Technical assistance in IPM implementation; 

 Increasing student involvement in IPM, such as integration of science clubs; 

and 

 Other actions and initiatives that foster interconnectedness and mutual support 

with demonstrated results.

For Questions and Assistance

Please contact Thomas Cook at cook.tom@epa.gov or 214-665-9731. 

We appreciate your willingness to work with us in developing our School IPM Awards 

program. We are grateful for the time you spent in developing your burden estimate to 

complete the award application. 

Sincerely, 

Thomas Cook, Lead 

Center of Expertise for School IPM 

Office of Pesticide Programs 
Dear Metropolitan School District of Pike Township: 

The U.S. Environmental Protection Agency (EPA) is developing a tiered awards program 

to recognize school districts across the country that are working towards, or have 

achieved, a level of success with their School Integrated Pest Management (IPM) 

programs. 

Before launching the awards program, EPA must meet the requirements of the Paperwork 

Reduction Act. One of these requirements is the completion of an Information Collection 

Request (ICR). Part of the ICR process requires the Agency to report the time it takes 

school districts to complete the award application. The outcome of this process is called a 

paperwork burden estimate. 

We have identified your district as a potential participant in our awards program. We are 

requesting your assistance in creating a paperwork burden estimate. We will be working 

with several districts to get their burden estimates for one of the five award tiers being 

developed. Your district is asked to provide a burden estimate for the Model of 

Sustained Excellence award. 

What we are Asking You to Do: 

Using the attached Model of Sustained Excellence award application form, record the 

time spent on paperwork in the table below along with the job title of the person(s) 

performing those activities. For example, for the third activity category (Gather 

information), record the types of tasks performed in this category, the job title(s) and 

number of employees performing this task, and the average number of hours spent by 

each employee on the task. An example of how to record the information is provided 

below. 
Respondent 

Paperwork Activity 

Category

Description of Category 

(Specific task performed)

Job Title and Number of 

Employees Performing this 

Task

Average Time (in hours) 

Spent by Each Employee

on this Task

Example: Gather 

information

Request information from 

schools IPM Coordinator, 1 1.5

Example: Gather 

information

Gather requested information 

and submit to district Administrative assistant, 4 5.0

1. Read instructions Read Application Guide and 

application for relevant Tier. Director, 1 2 hours 

2. Plan activities Plan gathering of information 

that will be submitted to EPA.

Director, 1 8 hours

3. Gather 

information

Canvass / Contact personnel 

from schools within the 

district to gather information 

for application. 

Director, 1

IPM Staff, 1 8 hours

4. Compile and 

review

Assemble data, evaluate for 

accuracy, appropriateness, 

and completeness. 

Director, 1

IPM Staff, 1 8 hours

5. Complete and 

submit paperwork

Complete all appropriate 

application documents and 

send to EPA. 

Director, 1

IPM Staff, 1 4 hours

6. Store/Maintain 

data

File and maintain copies of 

materials submitted to EPA. Director, 1 1 hour

Please return your responses to Tom Cook at cook.tom@epa.gov.

Our Timeline: 

Please provide the requested information within 30 days of receipt. 

Goal of the EPA’s School IPM Awards Program: 

EPA’s incentive-based awards program will recognize schools for implementing IPM. 

The program will take into account the unique challenges of each district when providing 

them with educational and recognition opportunities. There will be five categories of 

awards to represent the level of effort and success that each district achieves. 

What is IPM? 

Integrated Pest Management (IPM) is a sustainable approach to managing pests by 

combining biological, cultural, physical, and chemical tools in a way that minimizes 

economic, health, and environmental risks. Implementing a School IPM program creates 

a safer and healthier learning environment by helping to manage pests while reducing 

pesticide use, pest complaints, and children’s exposure to pesticides. 
EPA School IPM Awards 

Great Start Award 

The School IPM Great Start Award is presented to school districts that are in the 

initial stages of implementing effective IPM programs. Schools can qualify for this 

award by selecting an IPM Coordinator and creating a written IPM Policy. 

Leadership Award 

The School IPM Leadership Award is presented to schools and/or school districts 

with a senior-level commitment to establishing and maintaining sustainable IPM 

programs and relate IPM strategies to the framework for effective school IPM 

programs (i.e., Organize, Assess, Plan, Act, Evaluate, and Communicate). 

Excellence Award 

To merit the School IPM National Excellence Award, an applicant will tell the story 

of their IPM program in a way that demonstrates their program is comprehensive, 

effective, and moving towards being institutionalized as part of a comprehensive 

environmental health program. Specifically, EPA will look for evidence that: 

 the critical components that lead to program effectiveness (i.e., the Six Key 

Drivers of School IPM Program Success) are embodied in the school 

environmental health management program; 

 an established system exists to ensure consistent and sustained action to 

identify, address and prevent pest problems; and 

 the program is achieving results. 

Model of Sustained Excellence Award 

To merit a School IPM Model of Sustained Excellence Award, an applicant will tell 

the story of their IPM program in a way that demonstrates that the program is 

comprehensive, effective, and sustained and institutionalized as part of a 

comprehensive environmental health program. Specifically, EPA will require that

they: 

 have previously won the School IPM Excellence Award which shows that 

they have successfully implemented and sustained an effective IPM program; 

 have established long-term school IPM goals; 

 are tracking the results of their program; and 

 are utilizing district-wide communication and school IPM policies. 

Connector Award 

The School IPM Connector Award is designed to give national recognition to 

individuals and organizations whose actions improved school environmental health in 

their community, region, state, or the nation, with a special focus the connective spirit 

of the award. Examples include: 

 Development of innovative initiatives, approaches, tools, or resources that 

have contributed to improved school IPM and indoor environments; 
 Outstanding individuals and groups who have played a coordinating function 

to bring people or IPM programs together to provide mutual assistance and 

support for school IPM implementation; 

 Leadership/Mentorship of school or school district IPM programs; 

 Technical assistance in IPM implementation; 

 Increasing student involvement in IPM, such as integration of science clubs; 

and 

 Other actions and initiatives that foster interconnectedness and mutual support 

with demonstrated results.

For Questions and Assistance

Please contact Thomas Cook at cook.tom@epa.gov or 214-665-9731. 

We appreciate your willingness to work with us in developing our School IPM Awards 

program. We are grateful for the time you spent in developing your burden estimate to 

complete the award application. 

Sincerely, 

Thomas Cook, Lead 

Center of Expertise for School IPM 

Office of Pesticide Programs 
1 

School IPM Great Start Award

The U.S. Environmental Protection Agency’s (EPA) School Integrated Pest Management (IPM) 

Great Start Award is presented to school districts that have made a commitment to implement 

an effective Integrated Pest Management program and that have taken the first steps towards 

implementing IPM. The Great Start Award is one of five levels of IPM awards, which the EPA 

presents to school districts or individuals. To find out which level of recognition is the best fit for 

your district, visit [insert website]. 

Recipients of the School IPM Great Start Award will receive: 

• A “Great Start in School IPM” certificate signed by an EPA official; 

• Recognition on EPA’s web site – [insert web site]; 

• Access to topical webinars, trainings, events and recognition and mentoring 

opportunities; 

• Regular e-mail updates aimed at advancing your school IPM program. 

Eligibility 

For a school district to receive the Great Start Award, the district must: 

x Comply with all state laws; 

x Only allow pesticides to be applied by a certified pesticide applicator; 

x Have a designated IPM Coordinator that is receiving regular IPM training; 

x Have a written IPM Policy; 

x Complete a self-assessment using an IPM checklist which addresses the pest-conducive 

conditions and pest problems present in the district. 

How to Apply 

Interested candidates should complete the attached application and submit the application by 

e-mail, U.S. Mail, facsimile or special delivery services (Federal Express, United Parcel 

Services, etc.). 

E-mail: 

ATTN: [insert email]

Facsimile: 

ATTN: [insert facsimile] 

U.S. Mail (or Special Delivery): 

ATTN: [inset mailing address] 

The application is a fill-in form, which will allow you to save what you have filled in on your 

computer and submit it electronically via e-mail. 

Applications for the Great Start Award are accepted year-round on a non-competitive basis. For 

specific questions, contact the School IPM Awards Coordinator at [insert contact information]. 
2 

Guidance for Completing the Great Start Application 

Clarification of the terms used in the attached application, guidance about how to get started with 

IPM in your school district, and an IPM self-assessment checklist can be found at [insert 

website]. 

School System/District Information 

Please provide all of the information requested in the table below. Note: If the contact person for this 

application is not in school during the summer break, please provide additional contact information 

(e.g., cell phone, alternate contacts) to allow EPA to contact you if necessary about your application. 

The application is a fill-in form, which will allow you to type your answers directly into the 

form, save what you have filled in on your computer, and submit it electronically via e-mail. 

IPM Coordinator Contact Information

School System/District Name: 

Name of IPM Coordinator 

Title 

Department 

Address 

City, State, Zip Code 

Telephone 

Fax Number 

E-mail Address 

School System/District Profile

Total Number of Students 

Total Number of Staff 

Total Number of Facilities in Your 

System/District (e.g., 45 schools, 5 

educational support buildings) 

Age Range of All System/District Facilities 

(e.g., 5-90 years old) 

 

Total Square Footage (ft2) of All 

System/District Facilities (e.g., 1.5 million 

ft2) 

 

Total School District Budget 

Number of School Facilities in Your 

School System/District Participating in the 

School IPM Program 

 

 
3 

School System/District Information Statement of Compliance 

with State Law

I certify that _______________ School District is in compliance with the laws of the State of 

_________, including the laws that pertain to pest management and pesticide application. 

_________________________ ______________________________ _______________ 

Signature Print Name Date 

Your District’s Integrated Pest Management Program

Coordinator: Who is your district’s Integrated Pest Management Coordinator? When did this 

person become the IPM coordinator? What is the role the IPM coordinator in managing pests and 

pest-conducive conditions in your district? 

Education: Does your district’s IPM Coordinator receive at least eight (8) hours of training per 

year in Integrated Pest Management techniques? How or where does the coordinator receive this 

training? 
4 

Policy: Does your district have a written IPM Policy? A sample IPM Policy can be found at 

[insert link]. Please attach a copy of the written IPM policy to this application. 

Self-Assessment: Have you completed a self-assessment using an IPM checklist for some or all 

of the facilities in your district? An example of a self-assessment checklist can be found at [insert 

link]. For what portion of the facilities in your district has an IPM self-assessment been 

completed? Your application will be evaluated on whether you have completed a self-assessment 

for at least some of the schools in your district, not on the findings of the self-assessment. Please 

attach a copy of the completed checklist/s to this application. 

Certified Applicator: Are all pesticide applications in your district performed by a certified 

applicator? Please attach proof of certification to this application. 

Narrative: Please use the space below to detail any aspects of your district’s Integrated Pest 

Management program which you have not mentioned anywhere else in this application. 
1 

School IPM Leadership Award The U.S. Environmental Protection Agency’s (EPA) School Integrated Pest Management 

(IPM) Leadership Award is presented to schools and/or school districts who make a seniorlevel commitment to establish and maintain sustainable IPM programs. The Leadership 

Award is one of five levels of IPM awards, which the EPA presents to school districts or 

individuals. To find out which level of recognition is the best fit for your district, visit [insert 

website]. 

Recipients of the School IPM Leadership Award will receive: 

x A “Leadership in School IPM” certificate signed by an EPA official; 

x Recognition on EPA’s Web site – [insert website]; 

x Access to topical web conference calls, training, events, and recognition and 

mentoring opportunities; and 

x Regular e-mail updates aimed at advancing your school IPM program. 

Eligibility

For a school district to receive the National Leadership Award, the district must: 

x Meet all requirements of the Great Start Award, including compliance with all 

relevant state laws; 

x Form an Environmental Health/IPM Committee; 

x Provide IPM education for Custodial, Maintenance, Groundskeeper, Kitchen, and 

Health staff members; 

x Have a written IPM Plan in place; 

x Conduct monthly inspections including insect and rodent monitoring stations; 

x Provide pesticide use records and monitoring records; 

x Store pesticides properly and notify the public when they are used; 

x Maintain trash areas and keep dumpsters at least 50 feet from any school facility; 

x Use door sweeps; 

x Manage vegetation near buildings. 

How to Apply 

Interested candidates should complete the School IPM National Leadership Award application

and submit by e-mail, U.S. Mail, facsimile or special delivery services (Federal Express, United 

Parcel Services, etc.). Applications for the Leadership Award are accepted year-round on a noncompetitive basis. For specific questions, contact [insert contact information].

The application is a fill-in form, which will allow you to save what you have filled in on 

your computer and submit it electronically via e-mail. 

All applications may be submitted by e-mail, facsimile, U.S. Mail, or special delivery 2 services 

(Federal Express, United Parcel Services, etc.). 

E-mail: 

ATTN: [insert email]
2 

Facsimile: 

ATTN: [insert facsimile] 

U.S. Mail (or Special Delivery): 

ATTN: [inset mailing address] 

Guidance for Completing the Leadership Application 

Clarification of the terms used in the attached application can be found at [insert website]. 

School or School System/District Information

Please provide all of the information requested in the table below. Note: If the contact person 

for this application is not in school during the summer break, please provide additional 

contact information (e.g., cell phone, alternate contacts) to allow EPA to contact you about 

your application, if necessary. 

The application is a fill-in form, which will allow you to type your answers directly into the 

form, save what you have filled in on your computer, and submit it electronically via e-mail.

IPM Coordinator Contact Information

School System/District Name 

Name(s) of IPM Coordinator 

and IPM Team Members (if 

necessary, please include 

an additional sheet listing all 

IPM Team members) 

Title 

Department 

Address 

City, State, Zip Code 

Telephone 

Fax Number 

E-mail Address 

School System/District Profile

Total Number of Students 

Total Number of Staff 

Total Number of Facilities in 

Your System/District (e.g., 45 

schools, 5 educational 

support buildings) 

Age Range of All 

System/District Facilities

 (e.g., 5-90 years old) 

 

Total Square Footage (ft2) of 

All System/District Facilities 

(e.g., 1.5 million ft2) 

 

Total School District Budget 
3 

Number of School Facilities in 

Your School System/District 

Participating in the School 

IPM Program 

 

Please review the statements in each section and check all boxes that apply to your school or 

school district IPM program. 

School System/District Information Statement of 

Compliance with State Law

I certify that _______________ School District is in compliance with the laws of the 

State of _________, including the laws that pertain to pest management and pesticide 

application. 

_________________________ ________________________ _______________ 

Signature Print Name Date 

Your District’s Integrated Pest Management Program

Great Start Award: Has your district previously received the Great Start Award? If so, 

please state when your district received the award. If not, please briefly explain how your 

district meets the requirements of the Great Start award (information on the Great Start award 

can be found on the same website as the information for the Leadership award: [insert 

website]). 
4 

Environmental Health/IPM Committee: Please describe the structure, membership, 

responsibilities, and activities of your school district’s Environmental Health/IPM 

Committee. 
5 

Staff Education: Please discuss the IPM education your district provides for Custodial, 

Maintenance, Groundskeeper, Kitchen, and Health staff members. Make sure to note the 

frequency, duration, and structure of this education. If you have any documents used in this 

process, please attach them to this application.
6 

IPM Plan: Does your district have a written IPM Policy? A sample IPM Plan can be found at 

[insert link]. Please attach a copy of your school district’s IPM Plan to this application.

Inspections: Does your district conduct monthly inspections including the use of insect and 

rodent monitoring stations? Please explain your district’s process for carrying out these 

inspections. If you have any documents relevant for this item, such as a sample 

inspection form, please attach them to this application. 
7 

Pesticide Use and Monitoring Records: Does your district keep records of pesticide use 

and of the results of its monthly inspections? Please describe your district’s process for 

keeping these records and, if your district does so, reviewing and taking action based on the 

records. Please attach a copy of a pesticide use record used by your district to this 

application (can be a sample form or an actually used form). 
8 

Pesticide Notification and Storage: Does your district follow the recommended procedures 

for pesticide use notification and pesticide storage? Please describe how your district notifies 

the public of pesticide use and how pesticides are stored in your district. If you have any 

supporting documentation, such as a sample notification letter or posting, or photos of 

your pesticide storage area, please attach it to this application. 
9 

Trash Areas and Dumpsters: Does your district meet the requirements for proper 

maintenance, sanitation, and placement of trash areas and dumpsters? If you would like to 

provide photos of trash areas and dumpsters in your district, please attach them to this 

application. 

Door Sweeps: Has your district installed door sweeps on exterior doors and are the door 

sweeps of proper quality? Please mention, if available, the brand of the door sweeps your 

district uses. 

Vegetation near Buildings: What is your district’s policy regarding vegetation near 

buildings? Does your district meet the given requirements for visibility between structures 

and vegetation? 
10 

Narrative: Please use the space below to detail any aspects of your district’s Integrated Pest 

Management program which you have not mentioned anywhere else in this application. 
 

1 

School IPM Excellence Award The U.S. Environmental Protection Agency’s (EPA) School Integrated Pest Management 

(IPM) Excellence Award is presented to school districts that have implemented 

exemplary IPM programs The Excellence Award is one of five levels of IPM awards, 

which the EPA presents to school districts or individuals. To find out which level of 

recognition is the best fit for your district, visit [insert website]. 

Recipients of the School IPM Excellence Award will receive: 

x An “Excellence in School IPM” certificate signed by an EPA official; 

x Recognition on EPA’s Web site – [insert website]; 

x Access to topical web conference calls, training, events, and recognition and 

mentoring opportunities; and 

x Regular e-mail updates aimed at advancing your school IPM program. 

Eligibility 

For a school district to receive the Excellence Award, the district must: 

x Meet all of the requirements of the Leadership Award, including compliance with 

all relevant state laws; 

x Prove that the Environmental Health Committee, Pest Management Professional & 

school administration follow the IPM Plan proactively; 

x Update the IPM plan annually; 

x Provide IPM education and award certificates to all staff including teachers and 

coaches; 

x Conduct full quarterly inspections; 

x Keep detailed maintenance and pest complaint records; 

x Follow guidelines for pesticide selection and application; 

x Exercise proper sanitation including: proper food storage, clean and sanitary; 

kitchens and clutter-free classrooms and buildings; 

x Keep structures free of gaps, holes and other pest entry points; 

x Maintain the cleanliness of building exteriors. 

Instructions 

Interested candidates should complete the attached application and submit the application 

by e-mail, U.S. Mail, facsimile or special delivery services (Federal Express, United Parcel 

Services, etc.). 

 

E-mail:

ATTN: [insert email] 

 

Facsimile:

ATTN: [insert facsimile] 

U.S. Mail (or Special Delivery): 

ATTN: [inset mailing address] 

 
 

2 

The application is a fill-in form, which will allow you to save what you have filled in 

on your computer and submit it electronically via e-mail.

 

Applications for the Excellence Award are should be submitted by November 1st. 

Awardees will be selected by the following January. For specific questions, contact the 

School IPM Awards Coordinator at [insert contact information]. 

Guidance for Completing the Excellence Application 

Clarification of the terms used in the attached application can be found at [insert website]. 

School System/District Information 

Please provide all of the information requested in the table below. Note: If the contact person 

for this application is not in school during the summer break, please provide additional contact 

information (e.g., cell phone, alternate contacts) to allow EPA to contact you if necessary 

about your application. 

The application is a fill-in form, which will allow you to type your answers directly into 

the form, save what you have filled in on your computer, and submit it electronically via 

e-mail. 

IPM Coordinator Contact Information

School System/District Name: 

Name of IPM Coordinator 

Title 

Department 

Address 

City, State, Zip Code 

Telephone 

Fax Number 

E-mail Address 

School System/District Profile

Total Number of Students 

Total Number of Staff 

Total Number of Facilities in Your 

System/District (e.g., 45 schools, 5 

educational support buildings) 

Age Range of All System/District Facilities 

(e.g., 5-90 years old) 

 

Total Square Footage (ft2) of All 

System/District Facilities (e.g., 1.5 million 

ft2) 

 

Total School District Budget 

Number of School Facilities in Your 

School System/District Participating in the 

School IPM Program 

 

 
 

3 

School System/District Information Statement of 

Compliance with State Law

I certify that _______________ School District is in compliance with the laws of the 

State of _________, including the laws that pertain to pest management and pesticide 

application. 

_________________________ __________________________ _______________ 

Signature Print Name Date 

Your District’s Integrated Pest Management Program

IPM STAR: If your school district currently has certification through the IPM STAR 

program, it is eligible to receive the Excellence Award automatically. If your district is 

IPM STAR-certified, please attach documentation that confirms this certification to 

this application.

Leadership Award: Has your school district previously received the Leadership Award? If 

so, please state when your district received this award. If not, please affirm that your 

district meets the criteria to receive the Leadership Award. The requirements of the 

Leadership Award are available at this website: [insert website]. The IPM Plan is an 

especially important component of the Leadership Award criteria and is also necessary to 

meet the criteria of the Excellence Award. Please attach your district’s written IPM 

Plan to this application. 
 

4 

Coordination of IPM Plan, Committee, Administration, and Pest Management 

Professional: To qualify for the Excellence Award, a district must not only have an IPM 

Plan and Environmental Health/IPM Committee but also demonstrate that the Plan is being 

implemented and that the Committee is involved with the decisions of the district’s 

administration and pest management professionals. Please describe how your district’s pest 

management professional works with your district’s IPM Plan and how the Environmental 

Health/IPM Committee interacts with district administration and pest management 

professionals.
 

5 

IPM Plan Updates: To be successful, an IPM Plan must be adaptive to changing 

conditions and needs. The IPM Plan must be updated annually to meet the criteria of the 

Excellence Award; please describe the process by which your district updates its IPM Plan. 

Who is responsible for updating the plan? What factors are considered? 
 

6 

Staff Education: The Excellence Award requires that all staff, including teachers, coaches, 

and administrative staff, receive IPM education and certificates (see application guide for 

specific requirements). Please describe the education your district provides to staff. If you 

have documents used for IPM education, such as lesson plans or training modules, 

please attach it to this application.
 

7 

Full Quarterly Inspections: In addition to the monthly monitoring inspections required at 

the Leadership Award level, the Excellence Award requires that your district conduct full 

inspections on a quarterly basis. These full inspections should be conducted by the IPM 

Coordinator and at least one other member of the Committee, accompanied by the district’s 

pest management professional if the district contracts services from a pest management 

professional. Please describe the process used in these inspections. If you have any 

documents used for these inspections, please attach them to this application. 
 

8 

Pest Sighting and Maintenance Records: Please describe how your school monitors and 

records pest sightings and pest-related maintenance issues. Please attach the forms used 

for pest sightings and maintenance requests to this application. 
 

9 

Pesticide Selection and Application: Please describe your district’s process for 

determining when and how to use pesticides, which pesticides your district uses, and how 

frequently your district uses those pesticides. This includes any pesticides used by outside 

contractors. If you have a document explaining your district’s pesticide selection and 

application protocol, please attach it to this application. 
 

10 

Food Storage, Kitchen Sanitation, and Interior Clutter: How does your district control 

food storage, sanitation, and clutter so as to minimize pest-conducive conditions inside 

school buildings? It is advised that you submit a filled-in checklist (of the same type 

used in the Great Start Award application) to verify your district’s control of these 

factors. In addition, please attach to this application any other documents that might 

be helpful in establishing your district’s sanitation policies and conditions. 
 

11 

Entry Points: Please verify that your district’s structures are free of gaps, holes, and other 

entry points for pests. These are primarily on the exterior of buildings, although interior 

gaps should be addressed as well. Please explain the process by which your district 

monitors for entry points and addresses them when they are identified. It is recommended 

that you submit a filled-in checklist (as in the previous requirement) to verify your 

district’s control of structural entry points. 
 

12 

Exterior Clutter and Harborage: Please verify that your district controls clutter and 

harborage on school grounds. Explain how your district monitors for clutter and harborage 

and how it addresses it when it is identified. Again, it is recommended that you submit a 

filled-in checklist to support your application.
 

13 

Narrative: Please use the space below to detail any aspects of your district’s Integrated 

Pest Management program which you have not mentioned anywhere else in this 

application. 
 

1 

School IPM Sustained Excellence Award

The U.S. Environmental Protection Agency’s (EPA) School Integrated Pest Management 

(IPM) Sustained Excellence Award is presented to school districts that have been given 

the Excellence Award in the past and that have demonstrated the continued success and 

sustainability of their IPM programs. The Sustained Excellence Award is one of five 

levels of IPM awards, which the EPA presents to school districts or individuals. To find 

out which level of recognition is the best fit for your district, visit [insert website]. 

Recipients of the School IPM Sustained Excellence Award will receive: 

x A “Sustained Excellence in School IPM” certificate signed by an EPA official; 

x Recognition on EPA’s web site – [insert web site]; 

x Access to topical webinars, trainings, events and recognition and mentoring 

opportunities; 

x Regular e-mail updates aimed at advancing your school IPM program. 

Eligibility 

For a school district to receive the Sustained Excellence Award, the district must: 

x Have received the Excellence Award at least two years prior to applying for the 

Sustained Excellence award; 

x Presently meet all requirements for receiving the Excellence award; 

x Provide documentation of its method for making its IPM program sustainable; 

x Provide documentation of the results its IPM program has achieved; 

x Demonstrate how it has communicated about its IPM program both internally and 

externally. 

How to Apply 

Interested candidates should complete the attached application and submit the application by 

e-mail, U.S. Mail, facsimile or special delivery services (Federal Express, United Parcel 

Services, etc.). 

E-mail: 

ATTN: [insert email]

Facsimile: 

ATTN: [insert facsimile] 

U.S. Mail (or Special Delivery): 

ATTN: [inset mailing address] 

The application is a fill-in form, which will allow you to save what you have filled in on 

your computer and submit it electronically via e-mail. 

Applications for the Sustained Excellence Award for a given year should be submitted by 

November 1st. Awardees will be selected by the following January. For specific questions, 

contact the School IPM Awards Coordinator at [insert contact information]. 
 

2 

Guidance for Completing the Sustained Excellence Application 

Clarification of the terms used in the attached application, guidance about how to get 

started with IPM in your school district, and an IPM self-assessment checklist can be 

found at [insert website]. 

School or School System/District Information

Please provide all of the information requested in the table below. Note: If the contact person 

for this application is not in school during the summer break, please provide additional 

contact information (e.g., cell phone, alternate contacts) to allow EPA to contact you if 

necessary about your application. 

The application is a fill-in form, which will allow you to type your answers 

directly into the form, save what you have filled in on your computer, and 

submit it electronically via e-mail. 

IPM Coordinator Contact Information

School System/District Name: 

Name of IPM Coordinator 

Title 

Department 

Address 

City, State, Zip Code 

Telephone 

Fax Number 

E-mail Address 

School System/District Profile

Total Number of Students 

Total Number of Staff 

Total Number of Facilities in Your 

System/District (e.g., 45 schools, 5 

educational support buildings) 

Age Range of All System/District Facilities 

(e.g., 5-90 years old) 

 

Total Square Footage (ft2) of All 

System/District Facilities (e.g., 1.5 million 

ft2) 

 

Total School District Budget 

Number of School Facilities in Your 

School System/District Participating in the 

School IPM Program 

 
 

3 

Statement of Compliance with State Law 

I certify that _______________ School District is in compliance with the laws of the 

State of _________, including the laws that pertain to pest management and 

pesticide application. 

_________________________ _________________________ _______________ 

Signature Print Name Date 

Your District’s Integrated Pest Management Program 

Previous Excellence Award: When did your school district receive the Excellence 

Award? 
 

4 

IPM STAR: If your school district currently has certification through the IPM STAR 

program, it automatically meets the criteria of the Excellence Award (it still must 

demonstrate that it meets the additional criteria required by the Sustained Excellence 

Award, though). If your district is IPM STAR-certified, please attach documentation 

that confirms this certification to this application.

Leadership Award: Please affirm that your district meets the criteria to receive the 

Leadership Award. The requirements of the Leadership Award are available at this 

website: [insert website]. The IPM Plan is an especially important component of the 

Leadership Award criteria and is also necessary to meet the criteria of the Excellence 

Award. Please attach your district’s written IPM Plan to this application. 
 

5 

Coordination of IPM Plan, Committee, Administration, and Pest Management 

Professional: To qualify for the Sustained Excellence Award, a district must not only 

have an IPM Plan and Environmental Health/IPM Committee but also demonstrate that 

the Plan is being implemented and that the Committee is involved with the decisions of 

the district’s administration and pest management professionals. Please describe how 

your district’s pest management professional works with your district’s IPM Plan and 

how the Environmental Health/IPM Committee interacts with district administration and 

pest management professionals. 
 

6 

IPM Plan Updates: To be successful, an IPM Plan must be adaptive to changing 

conditions and needs. The IPM Plan must be updated annually to meet the criteria of the 

Sustained Excellence Award; please describe the process by which your district updates 

its IPM Plan. Who is responsible for updating the plan? What factors are considered? 
 

7 

Staff Education: The Sustained Excellence Award requires that all staff, including 

teachers, coaches, and administrative staff, receive IPM education and certificates (see 

application guide for specific requirements). Please describe the education your district 

provides to staff. If you have documents used for IPM education, such as lesson plans 

or training modules, please attach it to this application.
 

8 

Full Quarterly Inspections: In addition to the monthly monitoring inspections required 

at the Leadership Award level, the Sustained Excellence Award requires that your district 

conduct full inspections on a quarterly basis. These full inspections should be conducted 

by the IPM Coordinator and at least one other member of the Committee, accompanied 

by the district’s pest management professional if the district contracts services from a 

pest management professional. Please describe the process used in these inspections. If 

you have any documents used for these inspections, please attach them to this 

application. 
 

9 

Pest Sighting and Maintenance Records: Please describe how your school monitors 

and records pest sightings and pest-related maintenance issues. Please attach the forms 

used for pest sightings and maintenance requests to this application. 
 

10 

Pesticide Selection and Application: Please describe your district’s process for 

determining when and how to use pesticides, which pesticides your district uses, and how 

frequently your district uses those pesticides. This includes any pesticides used by outside 

contractors. If you have a document explaining your district’s pesticide selection and 

application protocol, please attach it to this application. 
 

11 

Food Storage, Kitchen Sanitation, and Interior Clutter: How does your district control 

food storage, sanitation, and clutter so as to minimize pest-conducive conditions inside 

school buildings? It is advised that you submit a filled-in checklist (of the same type 

used in the Great Start Award application) to verify your district’s control of these 

factors. In addition, please attach to this application any other documents that 

might be helpful in establishing your district’s sanitation policies and conditions.
 

12 

Entry Points: Please verify that your district’s structures are free of gaps, holes, and other 

entry points for pests. These are primarily on the exterior of buildings, although interior 

gaps should be addressed as well. Please explain the process by which your district 

monitors for entry points and addresses them when they are identified. It is 

recommended that you submit a filled-in checklist (as in the previous requirement) 

to verify your district’s control of structural entry points.
 

13 

Exterior Clutter and Harborage: Please verify that your district controls clutter and 

harborage on school grounds. Explain how your district monitors for clutter and 

harborage and how it addresses it when it is identified. Again, it is recommended that 

you submit a filled-in checklist to support your application.
 

14 

Program Sustainability: Please describe your school district’s strategy and efforts to 

make its School IPM program sustainable. If you have a written sustainability plan, 

please attach it to this application. 

Questions to consider: 

x Since winning the Excellence Award, what steps have you taken to put in place 

policies or procedures that ensure your IPM plan will be sustained on a long-term 

basis? 

x How has the role of your IPM Coordinator/IPM Team changed over time? How 

have you ensured the continued buy-in from team members, decision-makers, 

staff, and the community over the years? How do you keep staff and others up-todate on your program and changes in policies or procedures related to IPM? 

x What steps have you taken to ensure that your IPM program maintains top-level 

administrative support? For example, how do you engage new system 

administrators about IPM issues and your IPM program? How have you used 

administrators as advocates for your IPM program? 

x What obstacles have you encountered in advancing and sustaining your IPM 

program? What steps have you taken to address these obstacles? How has 

receiving a National Excellence Award helped you to advance your program and 

address challenges? 

x How do you maintain awareness of and support for your IPM program now that it 

is established (and may be “old news”)? How has receiving a National Excellence 

Award helped you to raise and sustain program awareness? 
 

15 
 

16 
 

17 

Program Results: Please provide documentation of the results your district has achieved 

using its School IPM program. Note that there are no quantitative requirements for 

success here; the intention in asking for documented results is to ensure that results are 

being collected. Possible items to document can include pest sightings, pesticide 

application changes, missed school days, asthma incidents, financial benefits, or any 

other quantities that can indicate IPM progress. Please attach your documented results 

to this application.

Program Communication: An effective communications strategy (both internal to the 

school system and external to the broader community) is a critical component of an effective, 

sustainable IPM program. In this section, describe how you communicate to your school 

community your IPM program’s goals, outcomes, and improvements, paying particular 

attention to how your communications have changed as your program has matured. It is also 

important to describe how you have used effective communications to ensure continued 

support for your program and whether you have provided assistance to other school systems 

seeking to improve their IPM. If you have a written communication plan, please attach 

it to this application. 
 

18 
 

19 

Narrative: Please use the space below to detail any aspects of your district’s Integrated 

Pest Management program which you have not mentioned anywhere else in this 

application. 
TABLE FOR CONNECTOR AWARD FROM IPM INSTITUTE

Respondent 

Paperwork Activity 

Category

Description of Category 

(Specific task performed)

Job Title and Number of 

Employees Performing this 

Task

Average Time (in hours) 

Spent by Each Employee

on this Task

Example: Gather 

information

Request information from 

schools IPM Coordinator, 1 1.5

Example: Gather 

information

Gather requested information 

and submit to district Administrative assistant, 4 5.0

1. Read instructions Read Application Guide and 

application for relevant Tier.

Project coordinator

Director

0.15

0.15

2. Plan activities Plan gathering of information 

that will be submitted to EPA.

Project coordinator

Director

0.15

0.15

3. Gather 

information

Canvass / Contact personnel 

from schools within the 

district to gather information 

for application. 

Project coordinator

Director

2.0

0.0

4. Compile and 

review

Assemble data, evaluate for 

accuracy, appropriateness, 

and completeness. 

Project coordinator

Director

6.0

0.5

5. Complete and 

submit paperwork

Complete all appropriate 

application documents and 

send to EPA. 

Project coordinator

Director

4.0

0.5

6. Store/Maintain 

data

File and maintain copies of 

materials submitted to EPA.

Project coordinator

Director

0.25

0.0
 

Page 1 of 9

School Integrated Pest Management Change Agent Award

The U.S. Environmental Protection Agency’s (EPA) School Integrated Pest Management (IPM) 

National Change Agent Award is presented to individuals and organizations that have contributed 

to the adoption and use of IPM policies in school districts at the community, state, region, or national 

level. The Change Agent Award is one of five levels of IPM awards which the EPA presents to 

school districts or individuals. To find out which level of recognition is the best fit for your district, 

visit [insert website].

Recipients of the School IPM Change Agent Award will receive:

• A “Change Agent for School IPM” certificate signed by an EPA official;

• Recognition on EPA’s web site – [insert web site];

• Access to topical webinars, trainings, events and recognition and mentoring opportunities; 

• Regular e-mail updates aimed at advancing your school IPM program.

Eligibility

For an individual or organization to receive the Change Agent Award, the individual or organization 

must:

 Provide a detailed account of their actions contributing to school IPM, with documentation of 

efforts to assess the results of those actions;

 Describe how they communicated with relevant educational entities (schools, school districts, 

state boards of education, etc.) to facilitate their IPM efforts;

 Demonstrate how their efforts will result in sustainable changes;

 Provide documentation of an endorsement from at least one educational entity in order to 

verify the significance of their activities.

How to Apply

Interested candidates should complete the attached application and submit the application by e-mail, 

U.S. Mail, facsimile or special delivery services (Federal Express, United Parcel Services, etc.). 

E-mail:

ATTN: [insert email]

Facsimile:

ATTN: [insert facsimile]

U.S. Mail (or Special Delivery): 

ATTN: [inset mailing address]

The application is a fill-in form, which will allow you to save what you have filled in on your 

computer and submit it electronically via e-mail.

Applications for the Change Agent Award for a given year should be submitted by November 1st. 

Awardees will be selected by the following January. For specific questions, contact the School IPM 

Awards Coordinator at [insert contact information].
 

Page 2 of 9

Guidance for Completing the Change Agent Application

Clarification of the terms used in the attached application, guidance about how to get started with 

IPM in your school district, and an IPM self-assessment checklist can be found at [insert 

website].
 

Page 3 of 9

Contact Information

Please provide all of the information requested in the table below. If you are submitting this 

application on behalf of an organization, please provide the organization’s information rather than 

your own unless indicated otherwise.

The application is a fill-in form, which will allow you to type your answers directly into the 

form, save what you have filled in on your computer, and submit it electronically via e-mail.

Contact Information

Name (Individual or Organization)

Name of Key Contacts (if Organization)

Title

Department

Address

City, State, Zip Code

Telephone

Fax Number

E-mail Address

Contact Information of Person Providing Endorsement

Name

Title

Organization

E-mail Address
 

Page 4 of 9

Your Contributions to School IPM

IPM Actions: Please provide a summary of your (or your organization’s) efforts contributing to 

the adoption, implementation, and/or improvement of IPM practices in the educational setting. 
 

Page 5 of 9
 

Page 6 of 9

Results: Please describe how you or your organization measured the results of your efforts. Note 

that the nature of such results will vary widely depending on the nature of the actions taken. 

Please attach any relevant results to this application.
 

Page 7 of 9

Communication: Please describe how you or your organization communicated with educational 

entities (schools, school districts, state boards of education, etc.) and other community members 

as part of your efforts toward advancing School IPM. If you have a written communication 

plan, please attach it to this application. 
 

Page 8 of 9

Sustainability: Please describe how you or your organization has ensured or will ensure that the 

changes resulting from your efforts will be sustained in the future, or how you or your 

organization has maintained or will maintain your efforts in the future. If you have a written 

sustainability plan, please attach it to this application.
 

Page 9 of 9

Endorsement: Please provide documentation of an endorsement from an educational entity 

involved with your efforts that verifies the significance of your IPM activities. This endorsement 

can come from any level of the educational system, but it should match the general level of your 

activities; if your work mostly was with individual schools or districts, an endorsement could 

come from a principal or superintendent, but if you worked on state policy issues, the 

endorsement should come from a state official or entity. The endorsement should be no more 

than one page single-spaced and should be placed on official letterhead. Please attach your 

endorsement to this application.