Please print, complete and return this form for the July 29-31,
2002 Annual Meeting (and/or Workshop) to:
Business Manager, Florida Entomological Society
P.O. Box 1007, Lutz, FL 33548-1206

Save $25.00! PRE-REGISTER BY WEDNESDAY, JULY 10 (Payment may be made at the meeting).
NOTICE: On-site registration may not be guaranteed a luncheon ticket!
All members must wear lapel badges to be admitted to program sessions!

Badge to read: _________________________________________________________
                                                                                        First name                                                             Last name
Affiliation ________________________________ City/State _________________________

Area of interest (1-2 words):  _____________  Free spouse badge (upon request) to read: _______________
REGISTRATION: Pre-registration must be received by Wednesday, July 10.

Full/Sustaining Member Pre-registration (includes 1 luncheon ticket) $100 ______
On-site registration (may include 1 luncheon ticket) $125  ______
Student Pre-registration (includes 1 luncheon ticket)  $30 ______
 On-site registration (may include 1 luncheon ticket) $30 ______
Honorary or Emeritus (must purchase luncheon ticket)  -- ______
Additional Awards Luncheon Tickets:       # of tickets _____ x $30 = $ ______
Termite Workshop, (Tuesday morning) $35  ______
I will need a copy of the program in my registration packet. Yes____  No____
Do you plan to attend the awards luncheon on Tuesday, July 30? Yes ___ No ___
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 
Annual dues for 2003*    Are you currently a member of the Florida Entomological Society?  Yes ___  No __
Regular $40 ______
VISA AND MASTERCARD ACCEPTED
Student $20  ______
Card #_____________________________________
Sustaining $65  ______  
Donations**  $ ______
Signature____________________________________
Total $ ______
* New members please give full mailing address, telephone, fax and email.
**Donations are tax deductible. Donations can be unrestricted, or designated to specific causes such as student travel or awards.

IF A RECEIPT IS NEEDED, PLEASE COMPLETE FORM BELOW (receipts will be available at registration desk):
Received from:_____________________________________________     $___________________
Registration: Annual dues for 2003:
Pre-registration $100 ______
Regular
 $40 ______
On-site registration $125 ______
Student 
 $20 ______
Student  $30 ______
Sustaining 
 $65 ______
Termite  Workshop $35 ______
Donations
 $ ______
 Additional awards banquet tickets _____ x $30 $ ______
Total
 $ ______
Received by: _____________________________________________