Membership Application/Update

To Apply, Renew or Update information for membership in the Ashtabula County Society for Human Resource Management, please complete and submit this on-line membership application. A space has been provide for additional comments. Thank You.

FORM TYPE New Member  Renew   Update Info
*NAME
*TITLE
*ORGANIZATION
ADDRESS
CITY 
STATE ZIP
*PHONE
Include area code
FAX
Include area code
 
*E-MAIL
Used to send chapter newsletter and other important information. Not to be used for other than chapter communication needs.
 
CURRENT OR FORMER ACSHRM MEMBER   Yes     No
*NATIONAL SHRM MEMBER?   Yes     No
IF YES, SHRM MEMBER NUMBER
*ARE YOU HR CERTIFIED?   Yes     No
New Applicants: Your Major  
 HR Duties
ADDITIONAL COMMENTS

Membership in the ACSHRM is extended to individuals who are active, retired or in transition and have/had "Major human resource responsibility."

Note: Items with a * will be posted to the membership roster. If for some reason you wish not to have information posted, please make a note in the comments section. Information will not be used for any purpose other than for chapter use.

An invoice will be sent to you.  Please remit  your membership fee within 20 days of receipt of invoice.

If you have questions or do not receive an invoice within two weeks, please call Jim Kulko at 440-593-7132 or jkulko@suite224.net .

Print this page for your records before submitting.