FlintRiverSHRM - Member Application

Prefix (Mr. Mrs. Ms. Dr. None)

* First

* Last

SHRM/HRCI Certification(s)

Company Name

Business Title

* Primary Area/function of HR Work

Brief Description of Present Duties and Responsibilities

Years or Months at Present Position

Chief Products/Services

Address

Address 2

City

State

Postal Code

Telephone

* Email

Fax

SHRM National Member Email

College Name & Degree

Other Degree or Certifications

How did you hear about Flint River SHRM?

If referred by a SHRM member, who?

Areas of Interest (Please indicate any areas in which you would be willing to assist our chapter:)

Specific comments or requests?

Member Application