NPMA Individual Membership Form

If you would like to join the National Petroleum Management Association, please use the Membership Form below.  Fill out the form and FAX it to (703) 583-1207.  If you prefer, you may fill out the form, print it, and mail it with a check to the address on the right.  One of our staff members will call you for validation and billing information.

NPMA Headquarters

4222 Fortuna Center Plaza, # 641

Dumfries, VA 22025

 

 Bronze Level

  $35.00

for 1 Year

 Silver Level

  $50.00

for 1 Year

 Gold Level

  $100.00

for 1 Year

 Black Gold Level

   $150.00 for 2 Years

$200.00 for 3 Years
Title First Name
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Phone # FAX #
Address Address
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Home E-Mail Address
Employer Job Title
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FAX # Website
Work E-Mail Address

American Express     Diners Club     Discover     Master Card     Visa
Name as it Appears on Your Credit Card:
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In the future, NPMA will provide an online locator service using a members directory.  It will enable you to look up members in which contact information will be returned.  If you would like to release your contact information, please check this box: