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Oklahoma City Association of Professional Landmen Membership Application

Section 1: User Information
First Name*

Last Name*

Initials

Company*

Position Title

Mailing Address*

City*

State*

Zip Code*

Address 2*

Country

Work Phone

Home Phone

Mobile Phone

Fax

Pager

E-mail*

Are You a Member of AAPL?:*    Select One Yes No

Are you a CPL?:*

Select One Yes No

Are you a RPL?*

Select One Yes No

Spouse:

Have you ever been indicted for or convicted of a felony?    SELECT ONE yes no

User Name*

Password*

confirm password

Section 2: Sponsor Information (2 Sponsors are Required - Sponsors will be contacted prior to member approval)

Referred By OCAPL Member Name:

Referred by OCAPL Member Name:

Section 3: User Information
Application is for (check one):      Active - available to professional landmen regularly engaged in Petroleum Land work with one year or more experience or a Petroleum Land Management/Mineral Land Management and/or Energy Management Degree from a recognized college or university. Where salaried his employer must be regularly engaged in the Oil and Gas business Associate - available to professional landmen regularly engaged in petroleum land work with less than one year experience and persons who are assoicated with petroleum land work who have one or more years experience.

How long have you been actively involved in land work?

State the type of land work performed (please be specific).

Section 4: Membership Type
Membership Type* $125.00 - Jan 1st - Dec 31st $80.00 - Jul 1st - Dec 31st

Section 5: Payment
Payment Method*     Credit card     Check

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