WV Land & Mineral Owners Association

Please complete this application in its entirety. Application is subject to approval by the WVLMOA Board of Directors, which meets bimonthly. If you have any questions, please contact our Executive Director, Carrie Bowe, at (304) 342-6970 or carrie@maplecreative.com.

Types of Membership

	Landowner Member: Landowning member having voting rights; includes up to ten (10) participants.
	Associate Member (Non-voting): Any company/individual who shares a common interest with the WVLMOA; includes up to three (3) participants.

Member Information

Member Name
Organization/Company
Type of Organization/Company
If landowner, estimated acreage
Address
City
State
Zip
Work Phone
Cell Phone
Home Phone
Cell Phone
Email

Member's Principle Representative

Member Name
Address
City
State
Zip
Work Phone
Cell Phone
Home Phone
Cell Phone
Email

	Acreage*	Membership Fee	Lobbying Assessment
	10,000+	$2,500	$2,500-$5,000
	5,000-9,999	$1,250	$1,250
	1,000-4,999	$750	$750
	Associate	$300	Voluntary
Additional Participants		x $50 each

* Calculation of member's acreage with undivided ownership.
Total acreage (fee, surface and timber, coal only, gas only, etc.)
__________ acreage x percentage or fractional ownership ___________ = Member's acreage.

Member's Participants
Landowner Members may have up to ten (10) participants and Associate Members may have up to three (3) participants. Additional participants may be added for $50 each. Participants must be listed in order to be considered a "Member" of the WVLMOA.