Columbia County Landowners Coalition

JOIN THE COALITION

Note: Please only fill out this form if you have at least one acre more or less. We cannot include smaller parcels at this time.

Name:
Mailing Address (road,city,state,zip):
Property Address (road,city,state,zip):
Township:
Number of Acres Owned (5 or more only):
Parcel Numbers:
Have you been contacted by any oil/gas company?:	YES / NO
What company / When?:
Have you signed a gas lease?:	YES / NO
Home Phone:
Cell Phone:
Best Time to Call:
Email: