Who are you?
---School DistrictPublic ParkChildcare CenterInstitutionResident
How did you hear about Good Neighbor Iowa?
FacebookOther social mediaRadioNewspaper articleFrom a friend or neighborTalking with someone in our organizationOther
Name of Childcare business or home
Address of childcare business or home
How many children do you care for?
Acreage of lawn area that is not sprayed (estimate if necessary)
We pledge to eliminate use of weed killers(herbicides) and insecticides on our grounds and playground areasYes
We pledge to disseminate information about pesticide harms provided by Good Neighbor Iowa to parents.Yes
We pledge to implement practices that significantly reduce the need for any pesticide application for indoor pests.Yes
We pledge to follow the guidelines outlined in CFOC Standard 18.104.22.168.: Integrated Pest Management regarding Integrated Pest Management in and around our facility.
Guidelines may be found at: http://cfoc.nrckids.org/StandardView/StdNum/22.214.171.124+ For further Integrated Pest Management resources, contact us at Good Neighbor Iowa.
It is okay to share our choice to pledge on social media, like Facebook and Twitter?
Good Neighbor Iowa uses social media to communicate our work with the public. We feel it is important to share with Iowans that childcare providers are eliminating pesticide use for the health of our children. With your consent, we may share information about your choice to pledge, and to celebrate your leadership in the state!
Questions or comments?
With your pledge, we will send you a free yard sign! Please choose the design you would like:
Yellow "Healthy Kid Zone"Pink "Pollinator Yard"Blue "Protect Our Water"Purple "Good Neighbor"Red, white & blue "Freedom Lawn"Teal "Healthy Pet Zone"I do not want a lawn sign
Name of School
Name of Point of Contact
Email of Point of Contact (if this is the same as above, leave this field empty)
Phone Number of Point of Contact
Name of Park
Name of Institution