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2020 Petroleum Club of WA Industry Awards

Young Professionals Membership Application

Please complete the application and submit for approval by the Board of Governors.
The application process will take up to 2 weeks to complete.

As per the PCWA Constitution and Club Rules, all membership fees apply from 01 July to 30 June.
Once your Membership has been approved an invoice will be issued to the email address provided on this form. As a member you will be able to access your invoices from the members-only section on our website. All fees are due and payable before 30 June each year for the following calendar year.

Petroleum Club Young Professional membership is open to those under 35 years of age.

ABOUT YOU

Title

Given Name

Family Name

Date of Birth

dd/mm/yyyy

I am a woman working in the oil and gas industry

Yes

I am of Aboriginal or Torres Strait Islander Origin

Yes

Business Telephone

Mobile phone

Primary email

Alternate Email

Please provide a personal email address

Company's Administrator or PA email

LinkedIn Profile

Please provide a link to your LinkedIn profile, if you have one.

Member Portal - Member Directory Privacy Settings

Once your membership has been activated, you will receive access to our member's only area. Within the member's area, we have a feature that allows you to search and connect with other members. By default, your privacy settings are set to be hidden.

If you would like your settings to be changed so members are able to view your profile, please choose the details you would like to share.

Add My Profile

Yes, I would like my profile to be included on the Member Directory feature No, I prefer to not be included on the directory at all

Let us know your concerns with joining the directory

Permission to show

Profile Photo Membership Level First & Surname Gender Contact Number Work Email Alternate Email (personal) LinkedIn Profile Link Organisation Job Title / Position

Please select all the options you wish to be visible on the Members Directory. (can tick multiple)

Upload Profile Photo

If you have a profile image or your company logo you would like added to your member profile, please upload here.

ABOUT YOUR WORK

Company Name (if self-employed please write your name)

Company Address

City, State, Country and ostcode

Postal Address (if different to above)

*A Member badge will be issued out to you once your membership has been approved, if you would like it sent to a personal address, please list address here.

What type of organisation do you work for?

What sector do you work for?

Which area or department do you work?

What is your role?

If other, please specify your job title

What year did you start working in oil and gas?

What other professional organisations are you a member of?

ABOUT THE CLUB

How did you hear about us?

Have you attended any of our events before?

Yes

Which types of events have your attended?

Industry Dinners, Sundowners, Gala Ball, Golf Day, Sailing, or as part of the Next Generation Schools Program

Why would you like to join?

Exclusive discounts, Facilitation of professional events and high profile speakers, a platform to build your network within the oil and gas industry; meeting other members and special guests and being part of a community?

APPLICATION APPROVAL

Please provide the names of your nominating members

applicants can be nominated and recommended by two (2) current financial members of the Petroleum Club. An applicant who does not know any financial members may leave this section blank and their application will be forwarded on to the Board for review.

Declaration: I agree to abide by the rules and regulations of The Petroleum Club of WA as set out in its constitution

I agree

Please review the Petroleum Club of WA Constitution

Please review the Petroleum Club of WA Club Rules

FEES AND PAYMENTS

Annual Fee: $90

Once your membership is approved, an invoice will be sent to the email address provided on this form.

Your membership will commence on receipt of payment.

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