South Puget Sound Designation Form
I hereby request that the Society for Human Resource Management (SHRM) list my primary chapter as South Puget Sound Chapter #0167.

I understand that:
(1) This is no way precludes membership in other chapters, and
(2) This allows SHRM to list my membership to this chapter for financial support program purposes only.

Email address *
National SHRM Member Number *
Not a National Member? Go to https://login.shrm.org/ (7-8 Digits, generally starts with a "0" or "1")
Your answer
SHRM Membership Type *
**Student Memberships -- please consider converting to a professional membership**
Last Name *
Your answer
First Name *
Your answer
Middle Initial *
Your answer
Certification *
Select all that apply
Required
Title *
Your answer
Company Name *
Your answer
Mailing Address *
Your answer
Apartment/Unit #/Suite
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Phone Number *
PLEASE USE THE FOLLOWING FORMAT: XXX-XXX-XXXX
Your answer
Signature *
Type your name below to sign
Your answer
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