SVSHRM.org - Members Directory

Membership Application

Thank you for your interest in joing SVSHRM! Please take a moment to fill out the application below.

Last Name:
First Name:
Nickname:
Your Current Job Title:

Status:	Salary Hourly Other
Are You A National SHRM Member:	Yes No
Member Number:
Certification (if applicable):

Current Primary Job Functions (including Yrs. Exp.)
Primary Job:
How Many Years of Experience:
Previous Job Functions (including Yrs. Exp.)
Previous Job:
Previous Job Years:
Previous Job 2:
Previous Job 2 Years:
Previous Job 3:
Previous Job 3 Years:
Previous Job 4:
Previous Job 4 Years:

Company Name:
Street Address:
Mailing Address:
City:
State:
Zip Code:
Business Phone:
Fax Number:
Email Address:	(E-mail)
Method of Payment:

The information above is factual and correct to the best of my knowledge:
Digital Signature (Please Type Your Full Name):
Date Signed:	(Date m/d/yyyy)

Referred By:
Name You Prefer For Your Name Badge (First and Last):

The chapter collects and maintains membership information as part of servicing your membership. We restrict access to this information about members to the chapter members, the chapter Board, Chair, and Committee members with a business reason to know this information in order to provide member services to our members. Members shall not use this information as a means to solicit business from other members (normal interaction at chapter meetings and events is permitted) nor shall any member share this information with non-members for any reason unless approved by the board.

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