The document is a membership application for the Oil, Gas, and Petro-Chemical Special Interest Group (SIG) of the Society for Maintenance and Reliability Professionals (SMRP). It requests contact information and payment details from applicants. Dues are $15 annually and will be prorated to align the SIG expiration date with the applicant's national SMRP membership expiration date.
Day in the Life of (DILO) of a Proactive Maintenance Technician
SMRP Oil and Gas Special Interest Group Application
1. SMRP Oil, Gas, and Petro-
Chemical SIG Membership
Please fax or mail this application with dues payment to:
SMRP-8400 Westpark Dr., Second Floor– McLean VA 22102
Fax: 703-610-0249
Name: ______________________________________________ Professional Title: ____________________________
Credentials (ie: CMRP, PE): _____________________________ Division/Department: __________________________
Company Name: _________________________________________________________________________________
Mailing Address: _________________________________________________________________________________
City, State, Province: _________________________________________________ Zip: _________________________
Country: __________________ E-mail: _________________________________________
Phone: ________________________________________ Fax: ____________________________________________
Dues are $15 annually, and will be pro-rated to bring your SIG
expiration date in sync with your national membership expira-
tion date.
How did you hear about SMRP? (circle one)
Colleague Publication Website Other ________________
Were you referred by a SMRP members? If so, please include name
______________________________________________________________________________
Payment Information
Payment Method: VISA MASTERCARD AMEX CHECK PO#______
Amount $ ________ Credit Card # ____________________________________ Exp. Date: ________________
Name on Card_______________________________ Signature: __________________________________________