Upload
prakhar-sarkar
View
222
Download
0
Tags:
Embed Size (px)
DESCRIPTION
Challenge bowl registration
Citation preview
Incorporating PESA’s Eastern Australasian Basins Symposium
International Conference& Exhibition 201513-16 September • Melbourne, Australia
TEAM MEMBER #1
Name: __________________________________ AAPG or SEG Mbr#: __________________________
Univ.: __________________________________________ Phone: _________________________________
Address: _________________________________________________________________________________
City: _________________________ State: __________________ Postal Code: _____________________
E-mail: ___________________________________________________________________________________
Year of studies: ________________________ Expected grad. Date: __________________________
Degree: ________________________________ Major: ________________________________________
Major: ________________________________________
TEAM MEMBER #2
Name: __________________________________ AAPG or SEG Mbr#: ____________________________
Univ.: __________________________________________ Phone: _________________________________
Address: _________________________________________________________________________________
City: _________________________ State: __________________ Postal Code: _____________________
E-mail: ___________________________________________________________________________________
Year of studies: ________________________ Expected grad. Date: __________________________
Degree: ________________________________
AAPG/SEG Challenge Bowl Registration Form
______________________________________(AAPG or SEG Student Chapter Name, if applicable)
BUSINESS OFFICE: P.O. BOX 979 / TULSA, OK 74101-0979 // Street Address: 1444 S. Boulder Ave. / Tulsa, OK 74119 // Phone: +1 918 560 2617 / Fax: +1 918 560 2684 / Email: [email protected]