How to use this form

tlang@aquariusaquarium.org

or print it out and mail via post to:

The Breeder's Registry
5541 Columbia Drive North
Fresno, California 93727
USA

Database Report Input Form

PERSONAL DATA: (this information will not appear on the on-line report)

--------------------------------------------------------------------------------
Name (Last, First):
Address:
City:	State:	Zip:	Country:
Telephone:	FAX:		E-mail:

Please check this box if you do not want the above information released in response to aquarist inquiries regarding this report (or species):

SPECIES DATA:

--------------------------------------------------------------------------------
Scientific name (Genus, species):
Reference used for scientific name:
Common name:			Geographic origin:
How long have you maintained organism(s):
Size:	Sex:	Size:	Sex:	Size:	Sex:
Describe any physical differences:
Broodstock notes:
Diet:
Frequency of feeding(s):

SPAWNING OR PROPAGATION METHODS:

--------------------------------------------------------------------------------
Describe any preparation(s) or pre-spawning activities:
.
Time of spawning:	Frequency of spawning:
Location of spawning:
Description of Spawn:	Size:
.
Size of eggs/fragment:	Approximate quantity:
Were eggs/fragment removed to a separate tank?
If so, how?
Describe development of eggs/fragment:
.
Incubation period:	Time of hatching:
Larvae attracted to light?
Additional comments:
.

ENVIRONMENTAL DATA (Spawning Tank):

--------------------------------------------------------------------------------
Capacity (Gallons):	DIMENSIONS	(Length):	(Width):	(Height):
Are sides or back covered?			What color?
Filtration:
Pumping volume (lph, gpm, etc.)
Type of seawater used:		Frequency/Volume of changes:

WATER QUALITY PARAMETERS (Spawning Tank):

--------------------------------------------------------------------------------
Specific Gravity:	How measured?	Source of replacement water:
pH:	How measured?	Temperature:	Fluctuation:
Nitrates:	How measured?	Calcium:	How measured:
Other parameters not listed:
Additives, medications added:
Frequency and dose:

PHOTOPERIOD (Spawning Tank):

--------------------------------------------------------------------------------
Lighting	Wattage	Photoperiod
#1	.	.
#2	.	.
#3	.	.
#4	.	.
Average distance from surface:	from organism:
How often do you change bulbs?

LARVAL DATA:

--------------------------------------------------------------------------------
Size at Hatching:			yolk sac present?
Description:
.
First food offered:			Frequency of feedings:
Second food offered:		When?	Frequency of feedings:
SURVIVAL -	week 1:	week 2:	week 3:	week4:
Long term survival:
When did metamorphosis occur?
Describe development:
.

If larvae were reared or settled in the same tank in which spawning occurred, please stop here and submit your report. If larvae were transferred to a separate Grow-out Tank, please continue completing the following information:

WATER QUALITY PARAMETERS (Grow-out Tank):

--------------------------------------------------------------------------------
Specific Gravity:	How measured?	Source of replacement water:
pH:	How measured?	Temperature:	Fluctuation:
Nitrates:	How measured?	Calcium:	How measured:
Other parameters not listed:
Additives, medications added:
Frequency and dose:

PHOTOPERIOD (Grow-out Tank):

--------------------------------------------------------------------------------
Lighting	Wattage	Photoperiod
#1	.	.
#2	.	.
#3	.	.
#4	.	.
Average distance from surface:	from organism:
How often do you change bulbs?

ENVIRONMENTAL DATA (Grow-out Tank):

--------------------------------------------------------------------------------
Capacity (Gallons):	DIMENSIONS	(Length):	(Width):	(Height):
Are sides or back covered?			What color?
Filtration:
Pumping volume (lph, gpm, etc.)
Type of seawater used:		Frequency/Volume of changes: