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Contact Information

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* Last

Suffix (Sr, Jr, II, III)

Maiden Name

Nick/Screen Name

* Email

* Gender

Applicant Information

* Address

Address Cont.

* City/Town

* State

* Postal Code

* Phone

Mobile

Alternate E-Mail

* Island

* Organization

* Are you self employed

* Job Title

Industry or Business Type

Website (Start With: "http://")

Alternate Address

Alternate Address Cont.

Fax

* Certification (type N/A if none)

* HR Experience

* Organization Size

* SHRM National Member

* SHRM National Number If you are a member of SHRM National, please provide the email address used for your account. If you are not a member, please type NA

* Union Organization

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More Information

Education/Experience

Social/Volunteer Organizations

Membership will be reviewed by the Board of Directors within 60 days of application.

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