GMA SHRM Membership Application
GMA SHRM
Current GMA SHRM Members: This is not the member renewal form!
Please use your GMA SHRM website login to pay your dues online or contact the chapter office for more information. Application fees are not refundable.

Application Instructions

Thank you for deciding to join GMA SHRM! Applications will be reviewed and added into membership upon completion of the application below and receipt of payment.
To join using:
  • Credit Card (Visa or MasterCard) – Complete sections 1 thru 8 below and complete by selecting "Submit Secure Payment".
  • Check – Complete sections 1 thru 7 below and print this page using your browser print option and return with check.
    Your registration will not be added until payment is received.
Section 1 - Information About You

Last Name:
First Name:
Middle Name:
SHRM Designation:
HRCI Designation:
Section 2 - Contact and Online Directory Information

Title:
Company Name:
Street Address:
Address 2:
City:
State:
Zip:
Phone Number:
Fax Number:
Email:
Section 3 - Member Referral Program
If you were referred to join by a GM SHRM member, please enter their name below.
Referer Name:
Referer Company:
Section 4 - Acceptance of Member Responsibilities
I hearby apply for membership in the Greater Madison Area Chapter of SHRM, Inc.  I understand that membership is ontingent upon the chapter's approval.

I pledge to read and abide by the Bylaws of teh Chapter, and to accept the responsbilities incumbent upon me as a members of the Human Resources profession.

I pledge to abide by the Code of Ethical and Professional Responsibility in Human Resource Managmenet ound at www.gmashrm.org.
Signature:
Date Signed:
Section 5 - Fees
Fee Schedule:
$15 - One-time application fee for all applicants.

$100-Local Only Dues - Greater Madison Area SHRM Inc. Chapter - National membership not required.
 
 
$75-Discounted Dues for National SHRM Members - You must already be a National SHRM member to receive the local GMA SHRM membership discount. 
 
Not already a National SHRM member? You can join National SHRM now to immediately receive your National SHRM ID#. Once you have your National SHRM ID#, enter that ID# below and receive the local GMA SHRM discounted dues rate. (National SHRM dues are approximately $180 and payable to SHRM, Alexandria, VA.) Note: National SHRM membership dues must be current and maintained during GMA SHRM membership year to qualify for discounted local rate. Please check the Chapter Designation box in Section 6, and enter your National SHRM member number in the box below.

Choose the Appropriate Dues Structure:
National SHRM ID#:
Section 6 - SHRM Primary Chapter Designation - To be completed by National SHRM members only
Chapter #53 | Greater Madison Area Chapter of SHRM, Inc. | AREA III
I hearby designate the above named chapter as my primary chapter for SHRM membership record keeping purposes. I understand that this designation:
  1. In no way precludes membership in other chapters.
  2. Allows SHRM to list my membership with this chapter for statistical, financial and record keeping purposes only.
If you have questions about your National SHRM membership, please call 1-800-283-7476

By checking this box, you are agreeing to the chapter designation and their terms listed above:
Section 7 - Demographic Information
Primary Reason for Joining GMASHRM:
Leadership/Volunteer Opportunities - Which of the following areas would you be the most interested in.
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