2015 WI Aquaculture Conference, March 6-7, 2015
REGISTRATION FORM
If needed, use extra sheet or form for each additional attendee
Name________________________________________________________________
Spouse_______________________________________________________________
Business/Organization____________________________________________________
Street _________________________________________________________________
City/State/Zip___________________________________________________________
Phone ____________________Email ________________________________________
Registration fees, per person.
Full 2 day and full 1 day registration includes: Friday lunch, Friday Taste of Wisconsin Aquaculture buffet,
Saturday lunch, 3 breaks & Friday evening reception
/person fee
# people
Total $
Friday “Seafood at It’s Best /Taste of WI Aqua Demo
$25
x _____
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Fri/Sat, Mar 6-7, WAA member
Fri/Sat, Mar 6-7, non WAA member
Additional person, same organization
Spouse
Student (High School or College)
Friday, March 6, only
Saturday, March 7, only
Saturday, incl Friday Taste of WI Aqua Demo
Saturday lunch only
$115
$145
$95
$65
$65
$85
$70
$85
$15
x _____
x _____
x _____
x _____
x _____
x _____
x _____
x _____
x _____
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Late fee, after Friday February 27
$25
x _____
____
Total $
____
Refunds: before Friday Feb 27: $25/person penalty, after Friday Feb 27: no refund
PAYMENT
You can pay by check, made out to WAA, OR pay by credit card - the following information must be completed:
Name on card _______________________________________________________
Billing address, include zip _____________________________________________
___________________________________________________________________
Credit card name - circle one: MasterCard, Visa
Credit card number/exp date____________________________________________
3 digit security code on back of card __________
Mail registration and payment to:
WAA, 1165 Riggles Gap Rd, Altoona, PA 16601