Tri-County Human Resource Management Association s1

TRI-COUNTY HUMAN RESOURCE MANAGEMENT ASSOCIATION Charleston, SC

MEMBERSHIP APPLICATION 2015 Applicant Information

Name ______Phone#: ______

Title: ______Fax#: ______

Company Name: ______E-mail: ______

Mailing Address: ______Certifications: _ PHR _ SPHR _ GPHR_Other National SHRM Member Number: ______Current Member _ Former Member

How were you referred to our Chapter? ______

Voluntary Statistical Data GENDER: ____male ____female AGE RANGE: ____ under 21 ____ 21-29 _____30-39 ____40-49 ____50-59 ____60 or older RACE/ETHNIC GROUP: ___ Hispanic or Latino ___ White (Not Hispanic or Latino) ___ Black or African American ___ Asian ___ Native Hawaiian or Other Pacific Islander ___ American Indian or Alaska Native ___ Two or More Races

Membership Categories

TCHRMA membership is granted on an individual basis. Memberships are non-transferable to other individuals. Please select one of the following:

____ A. Professional Member Membership shall be limited to (a) practitioners of human resource management at the exempt level for at least three years; (b) certified by the Human Resource Certification Institute; (c) faculty members holding an assistant, associate or full professor rank in human resource management or any of its specialized functions at an accredited college or university and have at least three years of experience at this level of teaching or less years of experience if they serve as an advisor to a student human resource club or chapter; (d) full-time consultants with at least three years experience practicing in the field of human resource management; and/or (e) full-time attorneys with at least three years experience in counseling and advising clients on matters relating to the human resource profession. Professional members may vote and hold office in the chapter. ____ B. Associate Member Membership shall be limited to those individuals in non-exempt human resource management positions as well as those individuals who do not meet the qualifications of the other classes of membership, but who demonstrate a bona fide interest in human resource management and the mission of the Chapter. Associate members may not vote or hold office in the Chapter. ____ C. Student Member Membership shall be limited to those individuals who are (a) enrolled either as full-time or part-time students, at freshman standing or higher; (b) enrolled in the equivalent of at least six (6) credit hours; (c) enrolled in a four-year or graduate institution and/or a consortium of these or a two-year community college with a matriculation agreement between it and a four-year college or university which provides for automatic acceptance of the community college students into the four- year college or university; (d) able to provide verification of a demonstrated emphasis in human resource management subjects, and (e) able to provide verification of the college or university’s human resources or related degree program. Student members may not vote or hold office in the Chapter. ____ D. Affiliate members: Membership shall be limited to those individuals whose companies provide products and/or services directly to the professional human resource community and who hold a current SHRM membership. No more than ten percent (10%) of the Association’s membership may fall into this category; because of this limit, no more than one person from any one organization may be an affiliate member. Affiliate members may not vote or hold office in the Association. Position/Company Information — Please complete the following:

A. Position Function ___ HR Generalist ___ Legal ___ Research ___ Employment/Recruitment ___ Health/Safety/Security ___ Consultant ___ Benefits ___ Employee Assistance ___ Administrative ___ Compensation ___ Employee Relations ___ Other - Specify ___ Labor/Industrial Relations ___ Communications ___ Training/Development ___ EEO/Affirmative Action ___ Organizational Development ___ HRIS

B. Company Size ___ Less than 25 ___ 100 -199 ___ 700 - 999 ___ 25 - 49 ___ 200 – 399 ___ 1,000 + ___ 49 – 99 ___ 400 - 699 ___ Consultant ___ N/A

C. Business/Industry Type ___ Agriculture, Forestry, Fishing ___ Services ___ Media ___ Manufacturing ___ Health/Health Care ___ Oil/Gas ___ Transportation ___ Real Estate ___ Library ___ Utilities ___ Educational Services ___ Other - Specify ___ Wholesale/Retail Trade ___ Government ______Banking/Finance ___ Construction ______

I hereby apply for membership in the Tri-County Human Resource Management Association and agree to pay the applicable membership dues. In applying for membership, I understand that my membership will not start until I am notified by the Association. I also agree to practice and uphold the ethics of the Association, abide by the By-laws and assist in carrying out the objectives of the Association.

Membership Year: January 1 - December 31 Annual Dues (select one): ___ $65.00 for Professional or Associate member if not a National SHRM member ___ $55.00 for Professional or Associate member if a National SHRM member (MUST include SHRM # on page 1) ___ $95.00 for Affiliate Members (MUST be a SHRM (National) member – include SHRM # on page 1) ___ Free for Student Members

NOTE: As the number of Affiliate Members is limited, Affiliate members must fax their membership applications to: 843-406-1015 and mail their checks to the address below or make payment at the next TCHRMA meeting. Affiliate membership is on a first-come, first-served basis until spaces are filled.

______Signature of Applicant Date

Please make checks payable to: Tri-County Human Resource Management Association (Taxpayer Identification Number 41-2244823) Forward payment with application to: Tri-County Human Resource Management Association P.O. Box 62722 North Charleston, SC 29419

For Membership Questions: Contact Juliana Leypoldt at [email protected] TCHRMA will invoice Members for bank fees associated with returned checks due to insufficient funds in the bank account of a Member or the issuance of a Stop Payment by a Member. TCHRMA Use Only Board Approval: Payment Information: Application Receipt Info: ______Cash Amount ______Date ______Check Number ______Time______