Texas Mining and Reclamation Membership Application

Joining As: (Check One):
Mining Company Investor-Owned Utility Municipal Co-op/Utility Support Member Individual Member
Company Name:
Mailing Information:
Address or P.O. Box
City:
State:
Zip Code:
Telephone: (please include area code)
Fax: (please include area code)
Type of company:
Corporation Partnership Sole Proprietorship
Person(s) to Receive TMRA Correspondence:
Name:
Phone:
Email
Address( if different from above)
Address or P.O. Box
City:
State:
Zip Code:

Name:
Phone:
Email
Address( if different from above)
Address or P.O. Box
City:
State:
Zip Code:

Type of mining activity and mineral resource mined; or products, equipment or services supplied to mining industry:

By submitting this form, you are digitally signing this form and agree to abide by the Bylaws of this association if accepted for membership.