APPLICATION FOR MEMBERSHIP

Please Use This Form To Renew or Apply For New Membership(s)
please type or print clearly & highlight any changes in your membership information 
Date:
Name (last/first/mi):
Spouse Name:                                                                         
Company: ____________________________________________________________
Title (If independent, please note):
Business Address:
City/State/Zip:
Business Phone: (_____) __________________     Fax: (_____) _____________________
Cellular Phone:  (_____) __________________
e-mail address:
Web-site:
Residence Phone : (        )                                                        
Are you a member of AAPL?           No____  Yes____   CPL___  RLP____
Please Indicate type of work performed:
_____________________________________________________________________________
Do you want your membership info published in the NLA web directory*
Yes _____    No  _____
*  (please note that the on-line web directory is passworded for member access only)
By-Laws - Nevada Landmen's Association - ARTICLE IV - MEMBERSHIP
Active membership in the Association shall be open: (a) to any person who is directly involved with and expends a considerable amount of his or her time in land work related to the minerals industry; (b) to any person who provides clerical or technical support for land work related to the minerals industry; or (c) to any person who is interested in the activities of the Association.  Every prospective member shall submit a brief application to the Executive Committee.
 Please send completed application & remittance of $30.00 for annual dues to:
NEVADA LANDMEN’S ASSOCIATION
 P.O. Box 21351
Reno, Nevada 89515-1351

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