Please print, complete and return this form for the August 5-8,
2001 Annual Meeting (and/or Ant Identification Workshop) to:
Business Manager, Florida Entomological Society
P.O. Box 1007, Lutz, FL 33548-1206

Save $25.00 PRE-REGISTER BY FRIDAY, JULY 13 (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 Friday, July 13th.

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 = $ ______
Ant Identification 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, August 7th? Yes ___ No ___
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 
Annual dues for 2002*                  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 2002:
Pre-registration $100 ______
Regular
 $40 ______
On-site registration $125 ______
Student 
 $20 ______
Student  $30 ______
Sustaining 
 $65 ______
Ant Identification Workshop $35 ______
Donations
 $ ______
 Additional awards banquet tickets _____ x $30 $ ______
Total
 $ ______

Received by: _____________________________________________