G. T. A. REGISTRATION FOR CONVENTION

If you are registering online to pay your Membership Dues, Renewal Dues and/or Registering to attend a Convention you *must* do the following: 

1. Fill out the form below and submit it to me.
2. Click on the PayPal Button and send in your payment.

DATE:
NAME - FIRST & LAST:
BUSINESS NAME :
E-MAIL :
AREA CODE & PHONE NUMBER:
BUSINESS PHONE NUMBER:
ADDRESS:
CITY:
STATE:
ZIP:
MEMBERSHIP DUES $60.00 yr. (Jan. 1 - Dec. 31):
FAMILY MEMBER $5.00 each:
LIST FAMILY MEMBER(S) NAMES:
CERTIFED DUES-$35.00 yr. (Jan. 1 - Dec. 31):
EARLY REGISTERATION-$35.00 per. family (Before Jan. 9):
LATE REGISTERATION-$50.00 per. family (After Jan. 10):
BANQUET TICKET-$25.00 per. person (12 yrs. & up):
CHILD BANQUET TICKET- $10.00 per. person (6 - 12 yrs):
PROFESSIONAL DIVISION-$20.00 (Specify wall or pedestal mount):
MASTERS OF MASTERS-$40.00 (Must register by Dec. 31):
COMMERICAL DIVISION-$15.00:
SPECIAL MOUNT-$15.00:
MASTERS OF MASTERS-$40.00:
HABITAT - $15.00:
CHARLIE FLEMING AWARD-$25.00:
HIGH SCORE POLYTRANSPAR FISH (no charge):
HIGH SCORE LIFETONE FISH (no charge):
SUPPLIER'S BOOTH - $50.00 each:
TOTAL AMOUNT:
Comments:

PLEASE MAKE SURE THAT YOU HAVE FILLED OUT ALL INFORMATION BEFORE SUBMITTING YOUR INFORMATION TO ME AND YOUR PAYMENT TO PAYPAL.