test membership - Gas & Oil Association of West Virginia

Are your business interests significantly tied to and dependent on the industry?*

Yes

Are you working directly in the West Virginia oil and gas industry?*

Yes

Are you an employer?*

Yes

Company name*

This application, and the questions below, are for the applicant identified here.

Name of individual representing applicant*

This person will be the company's contact person for GO-WV.

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

County*

Office Phone*

Office FAX

Mobile Phone*

Email*

Web Site

Please describe the role of applicant as it pertains to the West Virginia gas and oil industry*

Please provide the name of your parent company and/or list any and all subsidiary company(s) of which the applicant is a full or controlling owner*

Member
Any employer that is primarily engaged in the exploration, drilling, production, well servicing, gathering, processing, marketing, transportation, storage or distribution of oil, natural gas and/or NGLs, with operations in West Virginia and those employers that are significantly and directly involved in the West Virginia oil and gas industry and provide services, machinery, supplies and materials directly used or consumed in those activities, shall be eligible to become a “Member” of the Association.

Associate
Any individual or business that is engaged in providing ancillary services or activities related to or supportive of the oil and/ or natural gas industry not covered by subsection (a) or who otherwise does not qualify as a Voting Member, shall be eligible to become an “Associate Member” of the Association. Associate Members shall not have voting rights but shall be entitled to receive all Association membership communications and to participate in all Association meetings and events.

Only those who have significant involvement in the natural gas and oil industry in West Virginia, are employers and are approved for membership by the GO-WV Board of Directors are admitted as Members. Generally, an “employer” employs employees and: (1) has the power to hire and fire; (2) supervises and controls work schedules or conditions of employment; (3) determines the rate and method of payment; and (4) maintains employment records. Generally, an employer withholds taxes and social security payments from salaries or wages, and submits W-2 forms.

Although you may not be significantly tied to the industry or be an employer at this time, we welcome you to join with GO-WV as an Associate. If you check “no” to any of the qualifying questions below, you will be considered for approval as a GO-WV Associate.

Membership Type

Member

Associate

Member Categories*

Associate Categories*

Producer / Operator (Member)*

Producer/operator members pay $0.01 per mcf, with a minimum fee of $500 and a maximum fee of $35,000. Please calculate below based on mcf produced.

50,000 MCF or less

3,500,000 MCF or more

Between 50,000 and 3.5 million MCF

MCF Quantity*

Please enter a number from 50000 to 3500000.

MCF Price

Price: $0.01

Were you recommended or referred to GO-WV by someone?*

Yes

Who referred you to GO-WV?*

Would you like additional directory listings?*

For each $500 (or portion thereof) paid in annual dues, you will receive one database and directory listing. Additional listings are $75 each. Please submit additional listing information to info@gowv.com.

Yes

Additional Directory Listings

Price: $75.00

Total

Name

This field is for validation purposes and should be left unchanged.

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