Membership Application
DelMarVa SHRM
An Affiliate of the Society of Human Resource Management
Chapter # 0572
2008
Membership Application
Name:______________________________________ Certification _______
(Ex: SPHR, PHR)
Title_________________________
Are you a National SHRM member? Yes ? No ?
SHRM National #__________________________
Organization/Company______________________________
Address: __________________________________________
City_____________________________ State________Zip Code_________
Telephone #: ___________________Cell Phone#________________
Fax# _________________________ E-Mail _______________________
2008 Dues:
SHRM National members $ 30.00 DelMarVa Chapter dues for local
membership (National
Membership required.)
National ID#___________________
Non-National member $ 40.00 DelMarVa chapter dues for local
members who are not members of National.
Students Members $ 15.00 DelMarVa Chapter only. (Full time
student.)
Meeting Locations: Georgia House Restaurant
18 South Walnut St.
Milford, De. 19963
Meeting are held the third Tuesday, January – June, Sept.,Oct, and Dec.
Networking: 5:30 P.M.- 6: 15 P.M.
Dinner; 6:15 P.M.
Program 6:45P.M.-8:00 P.M.
Cost of Dinner:
Members $25.00
Non Members $30.00
Students $15.00
Comments_____________________________________________________________________________________________________________________________________
Number of years experience in Human Resources fields? ___________
What are your primary responsibilities in the field of Human Resources, or do you have a history of employment in the Human Resources profession? Please explain. ________________________________________________________________________________________________________________________________________________________________________________________________________________________
Are you a professional consultant in the Human Resources field? Please explain specialty area. ________________________________________________________________________________________________________________________________________________
Please list program topics you would find interesting._______________________________________________________________________________________________________________________________________
Mailing Address:
DelMarVa SHRM
P.O. Box 1169
Milford, DE. 19963