shrm primary chapter designation

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Please print out a hard copy of this form, complete it and US mail it to:

North Star SHRM
Sandy Fouquette
Liberty Paper, Inc.
P.O. Box 429
13500 Liberty Lane
Becker, MN 55308

NOTE: You must be a current national member of SHRM to apply.

Chapter Number: #0621       Chapter Name: North Star SHRM

I hereby designate the above named chapter as my primary chapter for SHRM membership coding purposes. I understand that:

1. This in no way precludes membership in other chapters.

2. This allows SHRM to list my membership to this chapter for financial support program purposes only.

NAME:
MEMBER ID:
COMPANY:
STREET ADDRESS:
CITY/STATE/ZIP:
DATE:
MEMBER'S SIGNATURE:
(Member must sign to validate.)

North Star SHRM
Becker, MN 55308