ATRS 2000 SUBSCRIPTION FORM

Subscriber’s Name_____________________________________________

Full Address__________________________________________________

(If P.O. Box – Please include Street Address) Contact

Person:______________________________________________________

Telephone #:__________________________________________________

Fax #:_______________________________________________________

Email:_______________________________________________________

Subscription @ $1,500.00 per subscription* $____________ ____________

Additional copies @ $80.00 per copy $____________

TOTAL PAYMENT ENCLOSED: $____________

Please make all remittances payable to:

ASSOCIATION OF SHIP BROKERS & AGENTS (U.S.A.), INC.

75 Main Street, Suite 104, Millburn, NJ 07401

*Two year subscription