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Application for DGS Membership
First Name
Email
Last Name
Phone
Street Address
City
Region/State/Province
Postal / Zip code
Country
Country
Company
Position
College/University
Degree
Major
Graduation Date (Anticipated if Student)
Second University (if applicable)
Second Degree (If applicable)
Second Major (if applicable)
Second Grad Date (if applicable)
AAPG Number (optional)
PG License State (Optional)
Addiotional Certificates
PG License Number (optional)
Select Memership Paymn Option
*
Professional Membership - $35
Associate Membership - $35
Student Membership - $5
Pay Offline via Check
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Thank you for submitting your application!
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