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ASSOCIATE MEMBERSHIP APPLICATION

THE AMERICAN ASSOCIATION OF PETROLEUM GEOLOGISTS, INC.
An International Geological Organization
P.O. Box 979, Tulsa, Oklahoma 74101-0979 USA • US & Canada: 800-364-2274 • (918) 560-2623
Fax: (918) 560-2694 • E-mail: join@aapg.org • www.aapg.org

❑ Ms. Initial Annual Dues $36. (after 2 yrs $72) • Outside North America $46. (after 2 yrs $82)
❑ Mr.
❑ Dr.
❑ Male ❑ Female ____________________________________________________________________________________________________________
Please print or type (Last name) (First) (Middle)

Employer ____________________________________________________________________ Position_______________________________________

Mailing Address ______________________________________________________________ Phone (______) ______ – ________________________

❑ Home ❑ Office
_____________________________________________________________________________ Fax (______) ______ – ___________________________

Date of Birth_____________ Place____________________ Citizenship_____________________ E-mail: ____________________________________

STATEMENT OF COLLEGE WORK
DATES INDICATE DEGREES
From To COLLEGE OR UNIVERSITY MAJOR FIELD RECEIVED
Month / Year Month / Year (Give Address) OF STUDY (Give Dates)

RECORD OF EXPERIENCE Resumé or CV may be substituted; or, attach additional pages if needed.
DATES
From To FOR WHOM
Month / Year Month / Year NATURE OF WORK Name Address

To the Executive Committee:

I have read the Constitution and Bylaws and Code of Ethics of the Association. (These documents may be found at www.aapg.org, or requested from
Headquarters office.) I recognize the need to enforce and protect a meaningful Code of Ethics, and I will hold blameless any member of the Association who
may, without malice, bring charges of wrongdoing against me, so long as my interests are protected and my right to defend against such charges is insured. If
elected to membership, I agree to abide by the provisions of these instructions now in effect, or as they may be hereafter amended; and I further agree that
said Constitution including the Bylaws and Code of Ethics shall be the sole measure of my rights, privileges, and obligations in the Association. I further
understand and agree that violation by me of any provisions of the Code of Ethics, as now existing, or as may be amended hereafter, shall be sufficient
grounds for my expulsion or suspension as may be decided by the Executive Committee.

I was recruited to join by:

Name of AAPG Member: __________________________________________________________________________________

Signature of Applicant ________________________________________________________________ Date_______________________

The AAPG BULLETIN is one of your member benefits and is available via Internet access (plus 6-mo
CD-ROMs) or printed copy. Please indicate your preference: ❑ On-line ❑ In Print

SIGNATURE OF SPONSOR REQUIRED ON REVERSE SIDE.

FOR AAPG USE

#: _____________________

Received_____________________________ Approved by______________________________ Notified____________________________

 Qualifications: Any graduate with a major in geology or an allied science from a college of
acceptable academic standards; or, any graduate with a non-geological major whose
employment is associated with geology, may apply. The Executive Committee may
waive degree requirements, if in its judgment an applicant has adequate
professional experience, and has attained professional standing.

Sponsor Must Be An ACTIVE AAPG Member. Assistance is available in finding a sponsor if necessary.

To the Executive Committee:

As sponsor, I have read the requirements for Associate membership in the AAPG, and, in my opinion the applicant is
applying for the proper classification.

Signature _______________________________________________________________________________ Date __________________________________________

Name (Print or type)_______________________________________________________ Position _______________________________________________________

Company__________________________________________________ Phone _______________________________________________________________________

Address __________________________________________________________________________________________________________________________________

Applicant Name: __________________________________________________________________________________________________________________________

OC
IAT
ION
OF PETR
OL
EU ENERGY MINERALS DIVISION serves geologists VI
M
RON ENTA DIVISION OF ENVIRONMENTAL GEOSCIENCES furthers the
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involved in non-petroleum energy resources, Association’s commitment to protect the environment
AS

GE

ISION OF E

GE
AN

OL
AMERIC

OGISTS

OSCIENC
including coal, coalbed methane, geothermal, oil and while developing natural resources in a responsible
gas shales, and tar sands, and geologists using remote manner.
IV

ES
D

N
N
E

ER IO
GY IS
M IN E R A L S DIV
sensing technologies in their work. AAPG

❑ YES I wish to join the DEG. I am enclosing the

❑ YES I wish to join the EMD. I am enclosing the additional amount for dues in this division.
additional dues required for this division, $20. N. America - $45 Outside N.Amer. - $55

Payment must be one of the following To pay by credit card, complete the information below.
methods.
❑ Master Card ❑ Visa ❑ American Express
1. Check or Draft – drawn in U.S. Dollars on a (16 numbers) (13 or 16 numbers) (15 numbers)
bank located in the United States or Canada
(usually one can obtain such a check or draft
❑ Discover ❑ Diners Club
(16 numbers) (14 numbers)
from a local bank).
2. Direct Bank Transfer – Bank of Oklahoma, Name of
N.A. Account #208322877, ABA #103900036. Cardholder (print): ______________________________________________________________
To ensure you receive proper credit, send
details of transfer, including name and Card Number: _____________________________________ Expiration Date: _____________
member number, to AAPG Accounting Dept.,
P.O. Box 979, Tulsa, OK 74101 USA; Fax (918) Amount of Payment
560-2652; E-mail: dlievsay@aapg.org. $
in U.S. Dollars: _________________________________________________________________
3. International Postal Money Order.
4. Credit Card. Signature: ___________________________________________ Date: _____________________

✔ Dues payments to AAPG are not a charitable contribution for U.S. income tax purposes; however, membership
dues are deductible for many members as an ordinary and necessary business expense.
✔ AAPG operates on a fiscal year: July 1–June 30. A $10 mailing surcharge is required for addresses outside
North America. Dues are prorated first year.
✔ Payment must accompany Application — will be refunded if the application is not accepted.

Attach payment for your MEMBERSHIP DUES AS LISTED ON THE FRONT of this application.
These DUES INCLUDE subscriptions to the AAPG BULLETIN and AAPG EXPLORER as follows:
AAPG BULLETIN $16.25/AAPG EXPLORER $3.25
Do not pay these amounts, pay the appropriate amount as reflected on the front of this application.
07/02