Register to Join

Prince William SHRM is a 100% chapter which means that membership is only available to those professionals who are members in good standing with National SHRM. If you are not a member of National SHRM, please click your back button, then click the "Become a SHRM Member" link to apply for national membership before completing this form. If you want to keep a copy of this form, print before clicking the "Create New Account" button.

Account information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

Your primary e-mail address where SHRM can contact you.

Confirm e-mail address: *

Please re-type your e-mail address to confirm it is accurate.

Personal Information

First Name: *

Last Name: *

Certification:

Business Title:

Company Name:

Address:

Address 2:

City:

State or Province: --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming- Other -

Postal Code:

Country: --United StatesCanadaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote D'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands(Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaS. Georgia and S. Sandwich Isles.Saint HelenaSaint Kitts and Nevis AnguillaSaint LuciaSaint Pierre and MiquelonSaint Vincent and GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin IslandsWallis and Futuna IslandsWestern SaharaYemenYugoslaviaZambiaZimbabwe

Telephone:

Fax:

Home Email:

Home Address: *

Home Address 2:

Home City: *

Home State: *

Home Postal Code: *

Cell Phone:

Home Telephone: *

National ID:

SHRM National ID (Not displayed in Member Directory)

If you recently applied for National membership, what date did you mail your application?:

Format: 05/16/2012

Primary Chapter Designation:

National SHRM recognizes only one chapter as your official or primary chapter. Prince William SHRM will be designated as your primary chapter unless you indicate another primary chapter designation. This in no way precludes you from being a member of more than one chapter.

What is your preferred postal communications address?: * BusinessHome

What is your preferred electronic communications address?: * BusinessHome

Are you interested in participating in a committee or volunteering?: * YesNo

Industry Type:

Company Size: --SmallMidLarge

Department Size:

Highest Level of Education: * High SchoolAssociatesBachelorsMastersPHDSome College

HR Area of Specialty: * GeneralistBenefitsCompensationEEO or DiversityEmployee RelationsHRISLegalOrganization DevelopmentRisk ManagementTrainingWorkforce PlanningConsultant

How did you hear about our chapter?:

How are you submitting payment of your dues?: * PayPalCheck