Become an INOGA Member
2008 Membership Dues Statement
Please complete this form and send with check to INOGA, Attn: CJ Mayhew, Membership Chairman, 6508 S. Uebelhack Rd., Mt. Vernon, IN 47620
| Company | _______________________________________________ |
| Contact Person | _______________________________________________ |
| Address | _______________________________________________ |
| Phone | _______________________________________________ |
| Cell Phone | _______________________________________________ |
| _______________________________________________ |
Do you want information e-mailed to you? YES NO
Make checks payable to Indiana OGA. Your 2008 dues are from January 1 – December 3.
Please check the one that applies to your Company:
| Producer | _____ | Pipeline | _____ | |
| Service/Supply | _____ | Gas | _____ | |
| Geologist | _____ | Insurance | _____ | |
| Attorney | _____ | Other(Specify) | _____ |
2008 DUES
$75.00 per person for full membership; $25 each for non-voting associate members.
(Multiple members from a company may become voting members if they choose to pay the full $75 membership fee)
($3 goes directly into Scholarship Fund)
Dues includes membership to the Oil & Gas Reporter
Extra Donation: ______________
Total Enclosed: ______________