Help for Completing the PEYA Application

Microsoft Word Document
PEYA Application [MWord, 3.0 MB]

If you have Microsoft Word installed on your computer, select the document, download it to your computer, and type in the information as required. Save the completed form and print a hard copy. Mail the hard copy to your EPA Regional PEYA Coordinator.

Adobe Portable Document Format (PDF)
PEYA Application [PDF, 6 pages, 301 KB, about PDF]

The interactive PDF application can be viewed using a PC or Macintosh computer. You must have Adobe Acrobat Reader installed on your computer to open the pdf form.
If you want to use the interactive PDF version, select the form and download it to your computer. You may either complete the form online or print a blank copy of the form to complete by hand. If completed online, print a hard copy of the completed form. Mail the hard copy to your EPA Regional PEYA Coordinator. Please note: you must print a hard copy of the completed form as the pdf form cannot be saved.

Please note: Hard copy versions of the forms will automatically revert to black-and-white if you do not have a color printer.