Title: Please print, complete and return this form for the August 5-9, 2001 annual meeting to:
Author: Joe Fed
Last saved by: r
Company: USDA-ARS

Please complete and return this form for the 
ANNUAL MEETING 
July 14-17 2013, Waldorf Astoria Hotel, Naples, Florida 
Business Manager, Florida Entomological Society
P.O. Box 1007, Lutz, FL  33548-1007
Fax 813-979-4908
Save $25.00  PRE-REGISTER BY FRIDAY JUNE 14th (Payment may be made at the meeting).  IT WILL SAVE MUCH TIME AND CONFUSION AT THE MEETING.  NOTICE:  On-site registration may not be guaranteed a luncheon ticket!
All attendees must wear lapel badges to be admitted to program sessions and award luncheon!

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, June 14, 2013.
FOR ALL ATTENDEES  (1) LUNCH TICKET GUARANTEE WITH PRE-REGISTRATION ONLY 
Pre-registration 				$160	______			Student
On-site registration 			$185	______			Pre-registration			$35_______
NON-MEMBER	(pre-registration/on-site)	$200	______			On-Site				$35_______	
One Day registration (no lunch ticket)	$90	______			
Workshop – Africanized Bees		$50	______									
Honorary or Emeritus (must purchase luncheon ticket)				______
Additional Awards Luncheon Tickets:		# of tickets          x $45=		______

Remember to download program from www.flaentsoc.org 				       
Do you plan to attend the awards luncheon on Tuesday, July 16?			Yes          No______         
*  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *    
Annual dues for 2013 or 2014 please circle which applies			Current member of FES Yes ______No______
	Corporate 	$250	_______					
	Regular		$40						 VISA/MASTERCARD ACCEPTED
	Student		$20		 
	Sustaining	$100						Card # ____________________________________	

	Donations**	$						Signature ___________________________________
	Total		$						
									Exp date____________________________________
*  New members please give full mailing address, telephone, fax and email on the back of form.
**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 2013 or 2014:
									Corporate	$250	_______
Pre-registration		$160						Regular		$40		
On-site registration	$185						Student		$20		
Non-Members		$200	_______
Student			$35						Sustaining	$100		
Extra Lunch #___X	$45	_______					Donations	$		
									New Member 		_______
Total				_______

Received by:								Total		$