LHRMA - Member Application

* First

* Last

* Title

* Company Or School if applying as a Student Member

* Business Address

* City

* State

* Zip

* Phone

* Email

* Are you a SHRM member?

SHRM # If you answered 'Yes' to the question above, please enter your number

* Organization Size

Years of HR Experience

Referral Source

Referral Name If you answered Individual, please list his/her name here.

Certification Level