GST Timelines -- Application for Membership

Application for Membership

Applicant: (Please print or type)

I hereby make application for membership in the Geophysical Society of Tulsa. If elected to membership, I shall abide by the Constitution and By-Laws* of the Society and shall endeavor to serve the Society to the extent of my ability.

*A copy of the By-laws is available from the GST Secretary, address and phone shown below.

Signature:		Date:

Annual dues are $20, payable January 1 each year. Dues for applicants elected to membership after January 1 are $10 for the remainder of that year. Students may apply for Student Membership with dues of $5 per year.

Membership Directory Information:

Last name:
First name:					Middle Initial:
Nickname:
Spouse's name:
Employer:
Position or Title:
Full Office Address:
Office Phone:
Full Home Address:
Home Phone:
Mail notices of meetings to:	Home?		or Office?
Email Address:
Professional Affiliations:	SEG Active	Associate	Student	Non-Member
Others:
Education:	School:			Degree:
	Major:			Year:

Please mail completed form and dues to the GST Treasurer at:
	Keith Willson Samson Two W. 2nd St. Tulsa, OK 74103-3103 (918) 591-1831 kwillson@samson.com