I am an AAPG Student Member and would like to request Chevron Corporation pay my AAPG Student dues.

I will be continuing school and would like my dues sponsored for FY2017 - 2018 dues (fiscal year ending June 30, 2018).

Yes, I wish to have Chevron Corporation pay my AAPG Student membership dues under the Corporate Sponsorship Program. I understand and agree that information about me contained in AAPG's records will be sent by AAPG to Chevron Corporation for use as determined solely by Chevron, and I hereby authorize AAPG to provide such information to Chevron.

By attaching the signature to this application form, I agree and understand that my typed electronic signature shall have the same legal effect as an original signature and is being accepted as my original signature pursuant to the Colorado Uniform Electronic Transactions Act, Colorado Revised Statutes, 24-71.3-101 et seq.


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