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 14, 2000
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) |
Additional Awards Luncheon Tickets: # of tickets ______ x $30 = $ ______
Regular $ 40 __ NO CREDIT CARD CHARGESAre you currently a member of the Florida Entomological Society? Yes ______ No ________
Student $ 20 __
Sustaining $ 65 __
Donations** $ ________Total $ ________
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 $30 =
$ ______
Received by: _____________________________________
Total $ ______
The Florida Entomological Society