Green Bay Area Chapter

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Green Bay Area Chapter Membership Application

First Name
Last Name
Are you a National Member?		Yes No
If yes, please provide ID#
PHR Certified?		Yes No
SPHR Certified?		Yes No
PREVIOUS HUMAN RESOURCES / BUSINESS
Title
Company
Company Address
Company Address 2
City
State
Zip
Business Phone (###- ###-####)
Business Fax (###- ###-####)
Email Address
Number of Years at Current Position
Primary Job Responsibiliteis
Please give the name, company, and phone number of an individual who can attest to the above:
PREVIOUS HUMAN RESOURCES / BUSINESS
From	To
Company
Company Address
Title
Responsibilities
Previous Human Resource Experience
Total Number of Years in Human Resources
I hereby apply for local membership in the Green Bay Area Chapter of the Society for Human Resource Management. I recognize and accept the responsibilities incumbent upon me as a member of the Human Resources profession. I pledge to abide by the Bylaws of the Chapter and understand that membership is contingent on the approval of the Board of Directors of the Green Bay Area Chapter of the Society for Human Resource Management.