Please print, complete and return this form to:
Teresa DuChene, Business Manager
Florida Entomological Society
P.O. Box 1007
Lutz, FL 33548-1007
PRE-REGISTER BY MONDAY, JULY 19, 1999!
 IT WILL SAVE MUCH TIME AND CONFUSION AT THE MEETING
All members must wear lapel badges to be admitted to program sessions

Badge to Read:       ______________________________________________________________________________
                                      (First Name)                                                                               (Last Name)
                                _____________________________________________________________________________
                                       (Affiliation)                                                                                    (City)
Area of Interest (1 or 2 words):____________________________________________

Free spouse badge (upon request) to read: _____________________________________________________________

REGISTRATION: Pre-registration must be received by Monday, July 19th

Full/Sustaining (includes 1 luncheon ticket) Pre-registration  $100  __
Full/Sustaining (includes 1 luncheon ticket) On site registration $125  __
Student (includes 1 luncheon ticket)  $ 30  __ 
Honorary or Emeritus     (must purchase luncheon ticket)
Do you plan to attend the awards luncheon on Tuesday, July 27th?                                    Yes    ___     No  ___
Additional Awards Luncheon Tickets:   # of tickets ______ x $25  =        $       ______
_____________________________________________________________________________________________________________
Annual dues for 2000*
Regular                      $ 40  __                                   NO CREDIT CARD CHARGES
Student                      $ 20  __
Sustaining $ 65  __
Donations**              $  _______
Total                          $ ________
Are you currently a member of the Florida Entomological Society? Yes ______  No ________
* New members please give full mailing address, telephone, fax & e-mail.
**Donations are tax deductible.  Donations can be unrestricted , or can be designated to specific worthy 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 2000:
Pre-registration        $100  __                                                   Regular                              $40 ___
On site registration  $125 __                                                    Student                             $20 ___
Student                      $  30 __                                                    Sustaining     $65 ___
              Donations   $______
Additional awards banquet tickets: ___ x $25 =                                            $    ______

Received by: _____________________________________      Total  $    ______
                              The Florida Entomological Society