[contact-form to=’contact@energyindustrysupport.com’ subject=’Oil %26amp; Gas Admins International Vendor/Supplier Membership Form and Directory Listing’][contact-field label=’First Name’ type=’name’ required=’1’/][contact-field label=’Last Name’ type=’name’ required=’1’/][contact-field label=’Job Title’ type=’text’ required=’1’/][contact-field label=’Business Name’ type=’text’ required=’1’/][contact-field label=’Home Country’ type=’select’ required=’1′ options=’United States,Angola,Argentina,Australia,Brazil,Canada,China,Colombia,France,Germany,Hong Kong,India,Indonesia,Ireland,Israel,Italy,Jamaica,Japan,Kazakhstan,Kuwait,Malaysia,Mexico,Namibia,Netherlands,New Zealand,Nigeria,Norway,Pakistan,Papua New Guinea,Philippines,Poland,Portugal,Qatar,Russia,Saudi Arabia,Senegal,Sierra Leone,Singapore,South Africa,Spain,Sri Lanka,Sudan,Sweden,Switzerland,Taiwan,Thailand,Trinidad and Tobago,Turkey,United Kingdom,Venezuela,Vietnam,Zimbabwe,Other’/][contact-field label=’Other Country’ type=’text’/][contact-field label=’Business Address’ type=’text’ required=’1’/][contact-field label=’Address continued’ type=’text’/][contact-field label=’City’ type=’text’ required=’1’/][contact-field label=’State’ type=’text’ required=’1’/][contact-field label=’Zip/Postal Code’ type=’text’ required=’1’/][contact-field label=’Business Phone’ type=’text’ required=’1’/][contact-field label=’E-mail’ type=’email’ required=’1’/][contact-field label=’Website’ type=’website’ required=’1’/][contact-field label=’Business Logo URL’ type=’website’ required=’1’/][contact-field label=’Business Type’ type=’select’ required=’1′ options=’Communications and Technology,Meeting and Event Services,Promotional Products,Promotions and Marketing,Public Relations,Transportation and Travel Services,Venues,Other’/][contact-field label=’Other Business’ type=’text’/][contact-field label=’Business Products and/or Services Description’ type=’textarea’ required=’1’/][/contact-form]