HR Leadership Group Membership Application

HR Leadership Group Membership Application
Name*

First NameLast Name
Preferred Email Address*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Title/Position*
Company*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Same as billing address?*
If no, please provide billing address information:
Choose your certifications/designations (choose all that apply):

MBASHRM-CPSHRM-SCPSHRM-BASKPHRSPHROther
Choose your current job function?*
Choose your industry:*
Referred By:*
Membership Information
Membership types - choose the type that best suits your job:*
What benefits or outcomes are you hoping to achieve through membership in the HR Leadership Group? (check all that apply)*

professional developmentSHRM certification creditsstrategic HR career growthknowledge of industry trendscareer advancementproblem solving & supportjoin a committeemeet HR peers/networkOther
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 years5-10 years10+ years
Provide your LinkedIn profile URL:
Upload your resume or LinkedIn profile:

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Membership Information