SHRM Primary Chapter Designation
Chapter #__________ Chapter Name_____________________________
I hereby designate the above named chapter as my primary chapter for SHRM membership coding purposes. I understand that:
- This in no way precludes membership in other chapters.
- This allows SHRM to list my membership to this chapter for financial support program purposes only.
Please type or print:
NAME____________________________________ SHRM MEMBER ID#_____________
(You must be a current national member of the Society for Human Resource Management to complete this form.)
COMPANY NAME___________________________________________________
ADDRESS____________________________________________________
____________________________________________________________
CITY/STATE/ZIP______________________________________________
PHONE# ___________________________________________
FAX ________________________________________________________
E-MAIL _____________________________________________________
| DATE ____ |
MEMBER'S SIGNATURE__________________________ |
|
(Member must sign to validate) |
Please fax to:
Member Relations
Fax: (703) 739-0399
|
