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:

• Individual Membership $50.00            ______

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: ________________