Membership Application
Name: ____________________________________________________________________________ Last First MI
Org. or Employer: ________________________________________________________
Job Title:_______________________________________________________________________
Address:____________________________________________________________________ Street#/PO Box City: ______________________________________ State: ____________________________________ Zip:____________________ Phone #:__________________________ Fax #: _______________________
Email: ______________________________________________________
Are you currently a member of SHRM: _____ Yes _____ No SHRM #: ___________________
Please send completed application form, along with a check for:
Send Completed Form and Check to: Southwest MI SHRM P.O. Box 751 St. Joseph, MI 49085 Attn: Membership Committee
As a member of SWMI SHRM, I will uphold its purpose and Code of Ethics:
Signature: _________________________________ Date: ________________
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Is this a new Member Application or a Renewal Application: _______