South Central Indiana Human Resources Association - Gold and Silver Application (SHRM Members)

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* National SHRM Member

Yes
No

* SHRM Membership Number

* First Name

* Last Name

* Title

* Email Address

* Company

* Years with Company

Work Experience

* HRCI Certification

* SHRM Certification

HR Interest Areas

* Work Address

* Work City

* Work State

* Work Zip

* Work Phone

Mobile Phone

* Please check here if you have read and agree to abide by the SCIHRA Code of Conduct

I acknowledge that I have read, and agree to abide by, the SCIHRA Code of Conduct as outlined

* Are you interested in joining a SCIHRA Committee?

Yes
No

* How did you hear about SCIHRA?

If other, please specify

What do you expect to gain through your membership in SCIHRA? (Check all that apply)

If other, please specify

Please list topics you are interested in hearing about at future events.

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