Name:
Job Title (as it is to appear in the membership directory): ______
Company Name:
Work Address:
City/State/Zip:
Work Phone:() Ext. Work Fax: ()
E-mail Address:
Home Address:
City/State/Zip:
Home Phone:()
Are you a current member of our national association, the Society for Human Resource Management (SHRM)?
No Yes: Member Number: Expiration Date:
Are you certified by the Human Resources Certification Institute (HRCI)? No Yes: PHR SPHR
Membership Status Applying for:
Regular National Membership: Individuals engaged in human resource management; or any individual certified by the Human Resource Certification Institute; or any faculty member with three or more years’ experience holding at least assistant professional rank in HR; or full time consultants with at least three years’ experience as an HR practitioner, or full-time attorneys with at least three years’ experience in counseling and advising clients on matters relating to the HR profession. Members in this category must belong to national SHRM and indicate an affiliation with our local chapter.
Local Chapter Membership: An individual who demonstrates to the satisfaction of the Board of Directors a bona fide interest in human resource management.
Retired Membership: Any member in good standing at the time of their retirement from any firm, organization, or institution may become a retired member.
Student Membership:
Please Check Your Functional Specialty:
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Revised 2/2013
Administrative
Benefits
Communications
Compensation
Consultant
Diversity
EEO/Affirmative Action
Employee Assistance Program
Employee Relations
Employment/Recruitment
Health/Safety/Security
HR Generalist
HRIS
Labor/Relations
Legal
Organizational Development
Research
Student
Training/Development
Other:
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Volunteers are very important to the continuation of our chapter.
Please indicate which areas you may be interested in volunteering. Thank You!
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Certification Rep.
Diversity /Workforce Readiness
Legislation
Programming Committee
Membership
Secretary
Seminar Committee
Student Chapter Liaison
Treasurer
Web Site
Other:
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I hereby apply for membership in the Winona Society for Human Resource Management, and agree to adhere to its
Bylaws and Code of Conduct.
- Members will maintain the highest standards of professional and personal conduct.
- Members will strive for personal growth in the field of human resource management.
- Members will maintain confidentiality of privileged information.
- Members will refrain from using their official positions, either regular or volunteer, to secure special privilege, gain or benefit for himself/herself.
Signed: ______Date: ______
I have enclosed:
$0Regular National Membership (National Application and Dues, currently $160, are to be paid to the address on the SHRM application).
$80Chapter Membership ($9 per month if joining mid-year) Make check payable to Winona SHRM and send to the address below.
$0Retired Membership
$0 Student Membership
Send Completed Application and Payment (if applicable) to:
or
Winona SHRM
P.O. Box 71
Winona, MN 55987
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Revised 3/2011http//winona.shrm.org