Petroleum Institute of Thailand

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MEMBERSHIP APPLICATION

We would like to support Petroleum Institute of Thailand with membership contribution at the following level.

Please fill in the following additional information.

Type of member A Full member An Ordinary member

Company's name (in English) *

ชื่อบริษัท (ภาษาไทย)

Product / Business

Address (in English) *

สถานที่ติดต่อ(ภาษาไทย)

Office phone * Mobile phone Fax

Website URL

E-Mail *

Primary Contact Person* (in English) *

นามผู้ติดต่อ (ภาษาไทย)

Title / Position (in English)

ตำแหน่ง (ภาษาไทย)

Phone * Fax

Email *

Company's Executive ** (in English) *

นามผู้บริหาร (ภาษาไทย)

Title / Position (in English)

ตำแหน่ง (ภาษาไทย)

Phone * Fax

Email *

* Primary Contact Person: is to be sent PTIT Focus, notifications and general announcements.
** Company's Executive: President, CEO, Board of Executives, or others in high level authority.

Full member :

Ordinary member :