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MEMBERSHIP APPLICATION - SHRM

New MEMBERSHIP MEMBERSHIP Renewal Ms. Mrs. Mr. Dr. Other Jr. Sr. Ed. JDFirst/Given NameNicknameMiddle Initial Last/Family NamePosition/Job TitleCompany NameCompany AddressCityState/ProvinceZIP/Postal CodeCountryPhoneFaxCompany EmailHome AddressCityState/ProvinceZIP/Postal CodeCountryPhone NumberFaxHome EmailSend Mail to: Home CompanyPreferred Email: Home CompanyAre you a member of a SHRM Chapter? If so, list the chapter name, city and state: Our member mailing address list is available to HR-related organizations. By checking this box, your name will be removed from this list. Allow 3-4 weeks for APPLICATION processing if mailed. Immediate membershipavailable at Full- or part-time students may be eligible for student MEMBERSHIP more information, visit SHRM MEMBERSHIP is nonrefundable and nontransferableMEMBERSHIP OPTIONS 1 year full MEMBERSHIP ( or Outside )$229 2 years full MEMBERSHIP ( or Outside )$413 1 year Global Online MEMBERSHIP (Outside Only)$109 Automatically Renew My MembershipBy selecting automatic renewal, upon the expiration of your initial member-ship (1 or 2 years after your MEMBERSHIP begins, based on the MEMBERSHIP option selected), SHRM will charge your credit card for the full MEMBERSHIP fee, based on the MEMBERSHIP option you have selected.

☐ Ms. ☐ Mrs. ☐ Mr. ☐ Dr. ☐ ... 25 29Labor/Industrial Relations 26 30Legal 27 Manage Outsourced HR 28 31Organizational Development 29 32Relocation 30 …

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