Indiana Aquaculture Directory Application

Indiana Aquaculture Directory Application

If you are involved in the Indiana Aquaculture Industry, then you may be included in the directory. To be included in the directory, please complete the form and submit the form. There is no cost to be listed.

Address:

Last Name:	First Name:
Company:
Address 1:
Address 2:
City:	State:	Zip Code:
Phone Number:	Fax Number:
Email Address:	Web Page:

Check all that apply:

Food Fish Producer:		Wholesaler:
Fingerling Producer:		Retailer:
Bait Producer:		Equipment Company:
Ornamental Fish Producer:		Live Hauler:
Sport Fish Producer:		Feed Producer:
Marketing Services:		Feed Retailer/Wholesaler:
Processing Services:		Disease Diagnostic Services:
Farm Pond or Lake Management Services		Regulatory Agency:
Fee-Fishing Operation:		Consultant Services:
Educational Services:		Other:

Please list the species of aquatic animals or plants you provide.

Atlantic Salmon:	Bluegill:	Channel Catfish:	Coho Salmon:
Crayfish:	Fathead Minnows:	Freshwater Prawn:	Goldfish:
Golden Shiner:	Grass Carp:	Hybrid Striped Bass:	Hybrid Sunfish:
Largemouth Bass:	Rainbow Trout:	Redear Sunfish:	Smallmouth Bass:
Tilapia	Walleye:	Yellow Perch:
Other: (please specify)

If you prefer you may print this form, complete and mail to:

Mark E. Einstein
Lilly Hall of Life Sciences
915 W. State Street
West Lafayette, IN 47907-2054