Membership Application Personal InformationPrefixSelectMs.Mrs.Mr.Dr.First Name *Last Name *Middle NameNick NameSuffixSelectIIIIIIVJr.Sr.HRCI Certifications PHR SPHR GPHR aPHR PHRca PHRi SPHRi HRBP HRMP SHRM-CP SHRM-SCP CSP CCP CBP CEBES CPP CHRS Not ApplicableBirth Month *SelectJanFebMarAprMayJunJulAugSepOctNovDecBirth Year *Select20092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960196019591958195719561955195419531952195119501949194819471946194519441943194219411940Gender IdentificationMaleFemaleNot SpecifiedYear Entered HR ProfessionHighest Level of Education CompletedSelectAAASBABSBBAMAMSMBAPhDJDOtherEthnicitySelectAmerican Indian/Alaskan NativeAsianBlack/African AmericanHispanic/Other LatinoHispanic/White LatinoMulticultural/OtherNative Hawaiian/Pacific IslanderUndisclosedWhitePrimary LanguageSelectAfrikaansArabicBrailleBulgarianCantoneseChinese - CantoneseChinese - MandarinCroatianCzechDanishEgyptianEnglishFinnishFrenchGermanGreekHebrewHindustani / HindiHungarianIcelandicIndonesianItalianJapaneseKoreanNorwegianPolishPortuguesePunjabiRomanianRussianSerbianSign Language (all forms)SpanishSudaneseSwedishThaiTurkishUkrainianVienneseVietnameseWelshNational SHRM Member Yes NoSHRM Membership NumberMembership Expiration DateAddressType Home WorkCompany NameJob TitleCountry/Region * Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo (Brazzaville) Congo Costa Rica Cote d\'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor (Timor Timur) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia, The Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Hong Kong Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Morocco Mozambique Myanmar Namibia Nauru Nepa Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands Yemen Zambia Zimbabwe Address Line 1 *Address Line 2Address Line 3Zipcode *City *State *Contact InfoEmail *Phone *Phone Type Home WorkActual Email *Email Type Home WorkCompany InfoCompany Size (overall) *Select1-2425-4950-99100-249250-499500-9991000-24992500-999910000-2499925000 and overIndustry *SelectAdmin, Waste Mgmt, Remediation SvcsArts, Entertainment, RecreationAssociation-Professional/TradeBiotechConstruction, Mining, Gas & OilConsultingEducation - College & UniversityEducation - K-12Educational ServicesFinanceGovt/Public Admin - FederalGovt/Public Admin - MilitaryGovt/Public Admin - State/LocalHealth Care - HospitalHealth Care - Non-HospitalHigh TechInsuranceManufacturingMgmt Companies, EnterprisesNonprofitOtherOutsourcingPharmaceuticalPublishing, Broadcasting, Other MediaReal Estate, Rental, LeasingRetail/Wholesale TradeSvcs - Accomodation, Food/Drinking PlacesSvcs - OtherSvcs - Professional, Scientific, TechnicalTelecommunicationsTransportation, WarehousingUtilities, Energy HR Dept Size (overall) *Select0-12-45-910-2425-4950-99100 and overUnit Level Within OrganizationSelectCorporateDivisionGroupOtherPlantRegionSubsidiaryOrganization TypeSelectGovt Sector - FederalGovt Sector - State/LocalNon-ProfitPrivately Owned For-ProfitPublicly Traded For-ProfitDoes Your Organization Operate Multinationally? Yes NoIs Any Part of Your Organization Unionized? Yes NoPosition InfoPosition Level *SelectAcademicianAdministrative AssistantAdministratorCHRO, CHCOConsultantCoordinatorDirector or Asst/Assoc DirectorLegal CounselManager, GeneralistOtherPartner, PrincipalPresident, CEO, ChairmanRepresentative, AssociateSpecialistSupervisorVP or Asst/Assoc VPNumber of Employees You Oversee DirectlySelect012-45-910-2425-4950-99100-499500 or moreWhich best describes Your Direct Supervisor's Job PositionSelectAdministratorCFOChief of Staff, Div Head, Dept ChairCHRO, CHCOCOODean, Superintendent, General ManagerDirector of HRExec Officer (Govt/Military)HR ManagerI'm Highest Ranked In My OrgOtherPartner, Principal, Executive DirectorPresident, CEO, ChairmanSVP of HR or other SVPVP Finance, ControllerVP of HRJob Function *SelectAdministrative SupportAdministratorBenefitsCommunicationsCompensationConsultant - IndependentConsultant - Multi-person FirmDiversityEEO/Affirmative ActionEmployee Asst. ProgramsEmployee RelationsEmployment/RecruitmentHealth, Safety, SecurityHR GeneralistHRISInternational HRMLabor/Industrial RelationsLegalManage Outsourced HROrganizational DevelopmentOtherRelocationResearchStrategic PlanningTraining/DevelopmentMembership DetailsPassword *Membership Level *Unpaid This box is for spam protection - please leave it blank:
