Contact Information

*Priority Code:

*Name of Host Organization:

*First Name/Forename (will appear on badge):

*Last Name (will appear on badge):

Title:

*Company (will appear on badge):

Telephone:

Fax:

*Email:

Street1:

Street2:

*City (will appear on badge):

*ZipCode:

*State:

*Country (will appear on badge):

Country of Residence:

Country of Citizenship:

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Society of Petroleum Engineers (SPE)	American Association of Petroleum Geologists (AAPG)
Society of Exploration Geophysicists (SEG)	American Institute of Chemical Engineers (AIChE)
Association for Iron & Steel Technology (AIST)	American Society of Civil Engineers (ASCE)
The American Society of Mechanical Engineers (ASME)	Society for Mining, Metallurgy & Exploration (SME)
Society of Petroleum Evaluation Engineers (SPEE)	Society of Petrophysicists and Well Log Analysts (SPWLA)
The Minerals, Metals and Materials Society (TMS)	American Rock Mechanics Association (ARMA)
None of the above

Exhibitor	Field Trip Leader
Panel Member	Panel Moderator
Session Chair	Short Course Instructor
Speaker (Technical Presenter)	Sponsor
Technical Program Committee Member

Academic	Economist/Financier
Engineer	Geologist
Geophysicist	Landman
Petrophysicist	Service Company Personnel (field technician, production supervisor, mechanic, etc)
Other

Demographic Information