Secure Individual Membership Form

If you would like to join the National Petroleum Management Association, please use the secure Membership Form below.  Fill out the form and click Submit.  You will receive a confirmation email.

This symbol denotes a mandatory field.

NPMA Headquarters

4222 Fortuna Center Plaza, # 641

Dumfries, VA 22025

 Bronze Level

  $35.00

for 1 Year

 Silver Level

  $50.00

for 1 Year

 Gold Level

  $100.00

for 1 Year

 Black Gold Level

   $150.00 for 2 Years

$200.00 for 3 Years
First Name  Last Name 
Phone Number  FAX Number
Address Line 1  Address Line 2
City  State 
Zip Code  Country
Home E-Mail 
Employer Job Title
Address City
State Zip Code
Country Phone Number
FAX Number Website
Work E-Mail

Master Card          Visa          American Express
Name as it Appears on Your Card 
Credit Card Number 
Expiration (MM/YY)  /

In the future, NPMA will provide an online locator service using a members directory.  It will enable you to look up members in which contact information will be returned.  If you would like to release your contact information, please check this box: