Do Not Spray/Opt Out

Enter text

By filling out this form, you are requesting to be on the opt-out list for the mosquito fogging program for the current mosquito season. You must understand that you will have to file another opt-out authorization next year.

Name: *

Are you the owner or renter of this property? *

Message:

Email: *

Check here to receive email updates

Phone *

Address *

My request is to: *

Be on the no-spray list

Be notified before spraying, then have my property sprayed

Today's Date *

By checking this box, you are understanding and agreeing that the spray applicator will make all attempts to avoid your property, but your neighbors may still want their property sprayed for mosquitoes. You also agree that should mosquitoes be found to be coming from your property, you have the responsibility to abate the mosquitoes before they become biting adults. *

I Agree to the above

Mosquito Control Program

City of South Bend, Washington

Mosquito Control Opt-Out Form

Environmenally Responsible Mosquito Control

Mosquito Control Program

​City of South Bend, Washington

City of South Bend, Washington