Member Application

ACCOUNT INFORMATION

Our annual memberships period is from January 1 - December 31. Our organization offers several membership levels:

General Membership $75.00
National Chapter Membership $50.00

You will be prompted to pay online after submitting your application. Please note that we do not accept checks.

* Email Address

Prefix (Mr./Ms./Dr.)

* First

Middle Name

* Last

Suffix (Sr, Jr, II, III)

Nick/Screen Name

Gender

Race/Ethnicity

* Your Birthday (12/31/1999)

* Home Address

Home Address Line 2

* Home City

* Home State

* Home Zip Code

* Mobile Phone Number (with area code) (XXX-XXX-XXXX) format

Alternate E-Mail

* Are you a current National SHRM Member?

* National SHRM Number/Primary Email If you are not a National SHRM member please write "N/A"

* Are you a current DelMarVa SHRM Member?

If you are a DelMarVa SHRM Member, please provide your email address on file with DelMarVA SHRM We will cross check your information with our partner, DelMarVA SHRM

* HRCI Certification

PHR
SPHR
GPHR
None

* SHRM Certification

SHRM-CP
SHRM-SCP
None

Are you An Emerging Leader

* Highest Level of Education

* Years in Human Resources

PROFESSIONAL INFORMATION

* Organization If you are currently in a work transition, please write "in transition."

* Your Title

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

* Company Address

Company Address Line 2

* Company City/Town

* Company Country

* Company State

* Company Postal Code

Phone (with area code) (XXX-XXX-XXXX) format

Fax

Bio

* Company Size

* Department Size

* Business Area

* Position

* Functions

Volunteer Interest

More Information

* How Did You Hear About Us?

If you were referred by a Delaware SHRM member, please list their full name here. We will send them a gift!

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