Decatur SHRM Chapter 555 - Member Application

* First

* Last

Title

* Company or Business Name

* Work Address

Work Address 2

* Work City

* Work State

* Work Zip

* Work Email

* Personal Email Since our employers may change we appreciate you providing personal contact information as well.

* Work Phone

Personal Phone Since our employers may change we appreciate you providing personal contact information as well.

Personal Address Since our employers may change we appreciate you providing personal contact information as well.

Personal Address 2

Personal City

Personal State

Personal Zip

Certification(s) Type how you wish your certification to be shown following your name. ie: SPHR, SHRM-SCP

Please check the certifications you hold.

* Are you a member of National SHRM? If so, please make sure to include you Membership ID below.

Yes
No

SHRM National ID

Describe Current Job Duties

How long have you worked for this employer?

How long have you worked in the HR Profession?

What is your education?

High School Diploma/GED
Associates Degree
Bachelors Degree
Masters Degree
Some College
Some Masters work

What professional or community organizations do you belong to?

Why do you want to be a member?

* Have you been a member of the Decatur Area SHRM in the past?

What do you feel you could contribute to the group?

Would you be willing to Volunteer? / Please Explain.

Have you ever held a board position before? Was it for a SHRM Chapter before? Explain

Would you be interested in being a Board Member?

What topics are you interested in learning more about?

Were you referred by someone? What is their name?