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Choose One:(Descriptions)
 Demographic Information: number of employees
1. Less than 50 4. 151-250
2. 50-100 5. 251-350
3. 101-150 6. 351+
Current SHRM Member: yes no
Membership Number:
Currently certified?
 No
SPHR
PHR
 Business and Industry: (select one)
Manufacturing
Education
Construction
Health Care
Finance
Service – Profit
Transportation
Government
Service – Non-profit
Real Estate
Insurance
Other
Utilities
Media
Fill in personal information:
*First Name:
*Last Name:
Title:
Company:
Mailing Address:
 
 
Street Address:
*Work Phone: Ext:
Fax:
Toll Free:
Work Email Address:
Website Address:
Home Address:
 
 
Home Phone: cell:
Home Email Address:
Short Biographical Essay:
(Between 250-750 words) 		*Bio will appear exactly as typed (line-breaks etc)
Send Mail to: Home    Business

I hereby apply for membership with the Lakes Area Human Resource Association and agree to pay the current membership dues upon notification of acceptance.
I AGREE

 
©2004 LAHRA - Lakes Area Human Resource Organization