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:

1. This in no way precludes membership in other chapters.
   
   
2. This allows SHRM to list my membership to this chapter for financial support program purposes only.

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 _____________________________________________________

Please fax to:

Member Relations
Fax: (703) 739-0399