CANADIAN ASSOCIATION OF

PETROLEUM LANDMEN

CML APPLICATION FORM

Application must completed and then

mailed or delivered to the CAPL office at:

1600, 520 – 5 Avenue SW

Calgary, AB T2P 3R7

FOR STAFF USE ONLY

Date Form Received / Date all Verification Received
Applicant Fees Received / Date
Date of Negotiator Publication

CANADIAN ASSOCIATION OF PETROLEUM LANDMEN

CML APPLICATION FORM

  1. PERSONAL DATA

Name: (First, Middle, Last) Click here to enter text.

Home Address: (Street, City, Province) Click here to enter text.

Postal Code: Click here to enter text.Home Phone: Click here to enter text.

Current Employer: Click here to enter text.

Business Address: (Street, City, Province) Click here to enter text.

Business Phone: Click here to enter text.Your Title: Click here to enter text.

E-Mail: Click here to enter text.

Where should mail be sent: Choose an item.

  1. QUALIFICATIONS FOR CERTIFICATION

I request acceptance to the CAPL CMLCertification by virtue of my qualifications under section A as stated in the Professionalism Procedure:

i) ☐ii) ☐ iii) ☐ iv) ☐

  1. EDUCATION

Years of Experience as a Landman (CAPL By-Laws Article 3.1(q)): Click here to enter text.

Post-Secondary Education:

College/University / Graduated (m/y) / Diploma/Degree / Area of Study
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. /
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. /
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. /

Mandatory Courses:

Category / Course Name / Date Attended
Ethics / Click here to enter text. / Click here to enter text. /
Fiduciary Duties / Click here to enter text. / Click here to enter text. /
Field Services / Click here to enter text. / Click here to enter text. /
Oil and Gas Law / Click here to enter text. / Click here to enter text. /
Negotiations / Click here to enter text. / Click here to enter text. /
Regulations / Click here to enter text. / Click here to enter text. /
Contracts / Click here to enter text. / Click here to enter text. /
  1. WORK EXPERIENCE – Attach Current Resume (Mandatory)
  1. SPONSORS

Applicants for CML must have three (3) sponsors, no more than two (2) of which, at the time of application, are employed or retained as a consultant by a common employer: each of whom is either an Active, Life or Senior member of CAPL; at least two (2) sponsors must hold either a P.Land® or PSL® designation from the CAPL or have a CPL or RPL designation from the AAPL. The sponsors will be required by the Certification Committee to describe on a separate form the applicant’s experience and attest to his/her ethics. Sponsors must know the applicant personally and be willing to attest to the applicant’s qualification, job experience, and ethical conduct. Sponsors may be required to answer other committee questions bearing upon applicant’s qualifications, and should not be named unless willing to supply such information.

The names and addresses of the three (3) sponsors are required on this application form. Please be sure each sponsor is provided with a verification form with full instructions. Verification forms can be found on the CAPL website.

Sponsor 1

Name: / Company: / Designation:
Click here to enter text. / Click here to enter text. / P.Land® ☐ PSL® ☐
Land Agent Lic. # Click here to enter text.
CPL ☐ RPL ☐
None ☐
Address: / Phone/Fax: / Email:
Click here to enter text. / Click here to enter text. / Click here to enter text. /

Sponsor 2

Name: / Company: / Designation:
Click here to enter text. / Click here to enter text. / P.Land® ☐ PSL® ☐
Land Agent Lic. # Click here to enter text.
CPL ☐ RPL ☐
None ☐
Address: / Phone/Fax: / Email:
Click here to enter text. / Click here to enter text. / Click here to enter text. /

Sponsor 3

Name: / Company: / Designation:
Click here to enter text. / Click here to enter text. / P.Land® ☐ PSL® ☐
Land Agent Lic. # Click here to enter text.
CPL ☐ RPL ☐
None ☐
Address: / Phone/Fax: / Email:
Click here to enter text. / Click here to enter text. / Click here to enter text. /
  1. FEES

The current Fee Schedule can be found on the CAPL website.

IN MAKING APPLICATION:

I hereby authorize the CAPL Certification Committee to verify all information herein.

Furthermore, I certify that all statements in this application are true to the best of my knowledge and I understand that any misstatement of facts deemed material is grounds for denial of my application. I further agree that in the event Certification is not granted to me, or if granted and later withdrawn for ethical reasons, I will make no claim against the Canadian Association of Petroleum Landmen – it’s Board of Directors, any committee, or any individual member.

Furthermore, I pledge that if I attain the CML designation, I will endeavor to maintain a high degree of professional competence, and moral and professional integrity.

Date Signature of Applicant

Name: Click here to enter text.

Page 1 of 4

Updated February 2016

CML Application Form