"Making Species Specific Diets for Decades!"

Club/Society Registration Form

Please email a Microsoft Excel (.xlsx), Comma Separated Values (.csv) or PDF roster with the name and emails of your club members to fish@hikariusa after completing the form.

Each year, we receive an increasing number of donation requests from Aquarium Societies, Koi and Pond Events, and various clubs from all over the United States. To help us decide whether to consider your group or event, we ask for a single member to complete the background information listed below. A business address is also required for shipments and deliveries. Groups that do not return a complete form will not receive consideration.

If you have any questions, please contact our customer service team at fish@hikariusa.com for more information.

Club Information:

Club Name required Total Number of Club Members required Current President required Current Secretary required

Contact Email required

Contact Phone required

Business Address Line 1 required Address Line 2

City required

State/Province required

Zip Code required

Frequency of Meetings Per Year required Total Number of Members that Attended Most Recent Meeting required

Total New Members in Last Year required

Total New Members in Prior Year required

Would your club or society like to be added to our email listing? required

Club Event Information:

Most Recent Major Event required

Event Date required

Event Location required

Total Number of Attendees required

Paid required

Non-Paid required

Normal Attendance W/O Your Show required Total Number of Exhibitors required

Dry Exhibitors required

Wet Exhibitors required

Total Number of Tanks

Total Number of Entries

Total Number of Fish Entered

Prove you're human! What is 6 + 4? required

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