Section 1. Information About You * Last Name: * First Name: Middle: Designation(s): Section 2. Contact and Online Directory Information Title: * Company Name:* Street Address: Address 2: * City, State Zip: Phone #: Fax #: * E-Mail:Section 3. Member Referral Program If you were referred to join by a GMA SHRM member, please enter their name below. Name: 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 contindent upon the chapter's approval I pledge to read and abide by the Bylaws of the Chapter , and to accept the responsibilities 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 Management found at www.gmashrm.org * Signature: Date: Section 5. Fees Fee Schedule: $15 - One-time application fee for all applicants. * Choose the appropriate dues structure below: Local Only Dues - Greater Madison Area SHRM Inc. Chapter - National membership not required. 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.National SHRM ID#: * This number is required to receive discounted GMA SHRM dues. 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: In no way precludes membership in other chapters. 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 Section 7. Demographic Information * How long have you been a Human Resources Professional? - SELECT ONE - 0-2 years 3-5 years 5-10 years 10-15 years More than 15 years * How many full and part time employees does your company employ? - SELECT ONE - 1-49 50-99 100-249 250-499 500-999 1000-2499 2500-4999 5000-9999 10,000-24,999 25,000 and over * What is your primary job function? - SELECT ONE - Administrative Benefits Compensation Consultant Diversity Employee Relations Employment Recruitment Health Safety Security HR Generalist HRIS Labor Industrial Relations Legal Managed Outsourced HR Organizational Development Other Relocation Outsourcing Strategic Planning Training – Development * Which of the following best describes your industry? - SELECT ONE - Admin, Waste Mgmt, Remediation Svcs Arts, Entertainment, Recreation Association–Professional/Trade Biotech Construction, Mining, Gas & Oil Consulting Education Finance Govt/Public Admin Health Care Insurance IT Mgmt Companies, Enterprises Manufacturing Other Outsourcing Pharmaceutical Publishing, Broadcasting, Other Media Real Estate, Rental, Leasing Retail/Wholesale Trade Services–Accommodation, Food/Drinking Places Services–Professional, Scientific, Technical Telecommunications Transportation, Warehousing Utilities, Energy * What is your job position? - SELECT ONE - Academician Administrator CHRO, CHCO Consultant Coordinator Director or Asst/Assoc Director Legal Counsel Manager/ Supervisor Other Partner, Principal President, CEO, Chairman Representative, Associate Specialist VP or Asst/Assoc VP Section 8. Payment Information * Choose a payment option below:
