Membership Registration Form Please enable JavaScript in your browser to complete this form.TitleMr.Mrs.Ms.Dr.ChiefName *FirstLastDate of BirthWHAT AGE CATEGORY DO YOU FALL UNDER? 18-30years31-40years41-50years51years and AbovePOSTAL ADDRESS:CityStateMobile NumberEmail *SKYPE IDWHATSAPP OR TELEGRAM NUMBERLINKEDIN LINKINSTAGRAM LINKINTERESTS: Example- Mentoring, Training, Researching, Fitness e.t.cADDITIONAL INFORMATIONPLEASE SELECT YOUR PREFERRED CONTACT METHODMobile NumberWhatsAppSkypeLinkedInInstagramCOMPANY NAMECOMPANY EMAILOFFICE ADDRESSPOSITION HELDBUSINESS ACTIVITIES RELATED TO THE ENERGY INDUSTRYUpstream/Exploration/ProductionMidstream/Marine/ShippingDownstream/RefiningPower: GenerationTransmissionDistributionGas- LNG/LPGRenewable EnergyServices/EPCGovernment ParastatalTraining/Capacity Building/EducationPublic Relation/Media/EventPlease select your membership type- Individual Membership : Open to all women who work in the energy space and have minimum of 3 years of experience. Affiliate Membership : Restricted to government agencies.Individual Membership ₦55,000.00Honorary Membership: By SelectionAffiliate Membership: By SelectionIndividual MembershipFor Individual membership, please send a reference letter from your HR and endorsement/signature by a current member of WIENARE YOU INTERESTED IN SERVING IN ANY OF THE EXECUTIVE LEADERSHIP COMMITTEE?Advocacy & Government RelationsCapacity BuildingConferenceFinance CommitteeRenewable EnergyMembership CommitteeLeadership/ Board CommitteeResearchSTEMPlease indicate if your are member of other associations such as: SPE, NSE, APWEN, EI, COREN NAPEPlease specify who you are regulated by: such as DPR, NIPEX,If others, please specify________File Upload- Personal Profile * Click or drag a file to this area to upload. Please upload your Personal Profile in pdf. (File should not exceed 6MB)File Upload- Letter of Commitment * Click or drag a file to this area to upload. Please upload your Letter of Commitment in pdf. (File should not exceed 6MB)File Upload - References * Click or drag a file to this area to upload. Please upload your References in pdf (File should not exceed 6MB)File Upload- Passport Photograph * Click or drag a file to this area to upload. Please upload your Passport Photograph. (File should not exceed 6MB)Payment Date (Leave Blank)MessageSubmit