APPLICATION FOR CORPORATEMEMBERSHIP*

*For corporationsdesiring to be members of Tennessee College and University

Professional Association for Human Resources (TN CUPA-HR)

Membership Period July 1, 2013 – June 30, 2014*

*Dues for the membership year are payable on August 1, but not later than January 31. Dues for joining during the second half of the membership year shall be one-half of the regular annual amount.

  • A corporation desiring membership should complete this application and submit payment of dues to the Treasurer (address below). Make checks payable to TN CUPA-HR.This form serves as an invoice.
  • Each Corporate membership is for one individual within the corporation. Other members of the organization may be added at the rate of $25 per person.

Dues/rates for membership:

$100 Corporate membership for one individual (please check)

Additional members at $25 each (list the names of Additional Members in Section 2)

TOTAL DUES TO BE SUBMITTED: $

SECTION 1.CORPORATE REPRESENTATIVE

1) Name Title

Corporation

Address

Telephone Fax

E-Mail Address

(List additional members on the next page in Section 2, as appropriate.)

Corporation:

SECTION 2.ADDITIONAL MEMBERS(from the same corporation, at $25 each)

2) Name Title

Address

Telephone Fax

E-Mail Address

3) Name Title

Address

Telephone Fax

E-Mail Address

4) Name Title

Address

Telephone Fax

E-Mail Address

Please send to:

TN CUPA-HR Treasurer, c/o Robynn Hopkins

University of Memphis Phone: (901) 678-2867

171 Admin Bldg Fax: (901) 678-1518

Memphis, TN 38152 E-mail:

5) Name Title

Address

Telephone Fax

E-Mail Address

6) Name Title

Address

Telephone Fax

E-Mail Address

7) Name Title

Address

Telephone Fax

E-Mail Address

8) Name Title

Address

Telephone Fax

E-Mail Address

(Please reproduce this page if additional pages are needed)

Please send to:

TN CUPA-HR Treasurer, c/o Robynn Hopkins

University of Memphis Phone: (901) 678-2867

171 Admin Bldg Fax: (901) 678-1518

Memphis, TN 38152 E-mail: