HR Leadership Group Membership Application
Name
*
First Name
Last Name
Preferred Email Address
*
example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Title/Position
*
Company
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Same as billing address?
*
Please Select
Yes
No
If no, please provide billing address information:
Choose your certifications/designations (choose all that apply):
MBA
SHRM-CP
SHRM-SCP
SHRM-BASK
PHR
SPHR
Other
Choose your current job function?
*
Please Select
HR Practitioner/Individual Contributor
Professional Level - HR
Professional Level - Non-HR
Consultant
Educator
Choose your industry:
*
Please Select
Agriculture, Forestry, Fishing and Hunting
Mining, Quarrying, and Oil and Gas Extraction
Utilities
Construction
Manufacturing
Wholesale Trade
Retail Trade
Transportation and Warehousing
Information
Finance and Insurance
Real Estate and Rental/Leasing
Professional, Scientific, and Technical Services
Management of Companies and Enterprises
Administrative and Support
Waste Management
Educational Services
Health Care and Social Assistance
Arts, Entertainment and Recreation
Accommodation and Food Services
Other Services (except Public Administration)
Public Administration
Referred By:
*
Membership Information
Membership types - choose the type that best suits your job:
*
Please Select
Consultant
HR Practitioner
Educator
Sponsor
What benefits or outcomes are you hoping to achieve through membership in the HR Leadership Group? (check all that apply)
*
professional development
SHRM certification credits
strategic HR career growth
knowledge of industry trends
career advancement
problem solving & support
join a committee
meet HR peers/network
Other
What motivated you to join the HR Leadership Group?
*
What skills or experiences would you bring to the HR Leadership Group?
*
How many years have you worked in the HR industry?
*
1-5 years
5-10 years
10+ years
Provide your LinkedIn profile URL:
Upload your resume or LinkedIn profile: (.pdf uploads only)
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