AAPG SPONSOR REGISTRATION FORM

The American Association of Petroleum Geologists

Print this form and fax/mail to Bill Dixon

International Country Sponsors

AAPG International Pavilion Sponsors

Pledge Amount: _____________

On Behalf of (company name) ___________________________________________________,

I hereby authorize sponsorship as indicated:

Signature: _________________________________ Date: __________________

Address:

___________________________________________

Tel: ________________________________

Fax: ________________________________

Circle one Option
Platinum	Gold	Silver	Bronze	Patron

Please make checks payable to AAPG International Pavilion Fund

Mail to:
Mr. Bill Dixon
c/o Triton Energy
6688 N. Central Expressway. Suite 1400
Dallas, TX 75206 Phone: (214) 691-5200 Fax: (214) 987-0571