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MEMBERSHIP APPLICATION CHAPTER #0619

Membership Categories Professional Member ______Limited to those individuals who Full Name are engaged as one or more of the following: (a) practitioners of HR ______management; (b) certified by SHRM or HRCI; (c) faculty Title members in HR management or any of its specialized functions at ______an accredited college or university;  Company Name  School Name (d) consultants or third-party associates practicing in the field of ______HR management; and/or (e)  Business Address  Home Address attorneys experienced in counseling and advising clients on matters ______relating to the HR profession. City State Zip Professional members may vote and hold office in the chapter. ______Associate Member  Business Phone  Cell Phone Individuals who do not meet the qualification of the other classes of May we text you meeting reminders to your cell phone?  Yes  No membership but who demonstrate a bona fide interest in HR ______management and the mission of the Email Address (NOTE: We use your email to notify of chapter updates and Chapter. Associate members may reminders via Constant Contact.) vote and hold office in the Chapter. How did you learn about the Grundy Will HR Association? Student Member Individuals who are (a) enrolled as ______full-time students; (b) enrolled in a 4-year or graduate institution Current member of SHRM? No Yes Membership #______and/or a consortium of these or a 2- year community college. Student Please be sure to indicate GWHRA #0619 as your primary chapter with members may not vote or hold SHRM!! office in the Chapter. Certifications:  SHRM-CP  SHRM -SCP GPHR SPHR  PHR Military/Veteran Member Individuals who are active duty or honorably discharged from any ______military branch or reserve unit of Signature Date military. Information shared on this form is shared with SHRM to verify affiliation.

Professional & Associate Member dues are $40 for calendar year, January – December. Members-in- Transition dues are discounted by 50%; Student Member dues are $5. Military/Veteran dues are waived. After July 1, dues for the remainder of the calendar year are prorated.

 Bill me via PayPal. (You will receive a secure link to pay via email.) Please scan and upload this form to [email protected] to initiate the PayPal invoice.  Send this form with a check made out to “Grundy Will HR Association” to GWHRA, 1147 Brook Forest Avenue #227, Shorewood, IL 60404