BEP Information Request

DISCLAIMER: This site does not constitute any offer to sell, or a solicitation of any offer to purchase a security. Any such offer will be done through a private placement memorandum and only to qualified Investors.

   Please provide your contact and qualification information:

** Full name: 

** Address: 


** City: 

** State or province: 

** Zip or postal code: 

** Country: 

** Telephone: 

** E-mail address: 

** Occupation: 

Highest education: 

Energy investments are: 

** Entity: 

If "other" please describe: 

Comments or questions: 

Note:  Fields marked ** are required!

Striving for American energy independance one well at a time!