Member Application

*First Name
*Last Name
Employer
Title
Organization's Address
City
State
Zip
Organization's Phone
FAX
Email
Home Phone
Home Address
City
State
Home Zip
Number of Years in Current Position
Exempt
Total Number of Years in Profession
Certification
    SPHR
    PHR
    Other
SHRM Membership #
SHRM Expiration Date
College
Degree/Diploma
Major/Minor
Nature of Work in Current Position
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PREVIOUS EMPLOYMENT IN HUMAN RESOURCES OR INDUSTRIAL RELATION:
Organization
Address
Position/Title
Number of Years
Organization
Address
Position/Title
Number of Years
Organization
Address
Position/Title
Number of Years
*Membership Type Applied for
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Online Meeting Registration - Membership Management - Event Management for Associations with local chapters.