| Cost | Number | Total US$ | |
| Early Registration | $ 300 | x | $ |
| Normal Registration | $ 350 | x | $ |
| Late Registration | $ 450 | x | $ |
| Extra Banquet ticket | $ 30 | x | $ |
| Extra copy of ISTA V Proceedings | $ 50 | x | $ |
| Student Registration (assist with audio-visual, no meals) |
$150 | x | $ |
| Bus Tour to Tilapia farms | $ 45 | x | $ |
TOTAL ENCLOSED $__________
Cash or Check enclosed: ___
OR
VISA___ MC___ American Express ___ Credit Card Number_______________________
Expiration Date: ___/___/___ Signature:______________________________
Name: __________________________
Address:_________________________
__________________________
__________________________
E-mail address ____________________
Registration may be by check, money order or credit card. Registrations will be accepted on-site. Make checks payable to ISTA V. Make sure to sign the registration form if paying by credit card. Mail completed registration and payment to:
American Tilapia Association
1901 North Fort Meyer Dr., Suite 700
Arlington, Virginia
22209