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Chesapeake
Human Resources Association Membership Application
Printer Friendly
Format
***CHRA's Membership year runs from June 1st - May 31st.
If you are joining in a month other than June please see below to calculate
your prorated membership amount.
If you have any questions please contact CHRA at 410-752-3318.***
MEMBERSHIP
CATEGORY (See member categories in brochure)
Please check member category
__ Professional Active (*SHRM member): $75.00 (includes current
/ previous HR practitioners or Academicians) -
(prorated amount $6.25 per month)
__ Professional Active (non-SHRM): $90.00
(prorated amount $7.50 per month)
__ Professional Affiliate: $90.00 (includes HR Consultants, Recruiters,
Service Providers) Service description:
(prorated amount $7.50 per month)
__ Associate: $90.00 (individual who does not meet the criteria
for the Active Category but shall seek a degree in HR or professional
certification)
(prorated amount $7.50 per month)
__ Recent Graduate (CHRA student members 1st year out of school):
$30.00
(prorated amount $2.50 per month)
__ Student (*SHRM member): $5.00
__ Student (non-SHRM): $15.00
*SHRM members must provide Membership ID below.
FOR ALL MEMBERSHIP APPLICANTS:
First Name______________________ Last Name:________________________________
M.I.__
Job Title: ______________________Nickname:______________________
Professional Certification: __SPHR __PHR __ GPHR __CCP __Other SHRM Membership
ID: _______
Name of Employer: _______________________________________________________________
Address: _______________________________________________________________________
City: ______________________________ State: ___Zip: _______________________________
Telephone: ________________ Fax: ________________ Email Address: ___________________
Home Address: ________________________________________________________________
City: ______________________________ State: ________ Zip: ________________________
Home phone: ________________ Home Email Address: _____________________________
Did someone refer you to CHRA? If so please provide that persons name
so we can acknowledge them:
Member Demographic
Information CHRA uses the following information in planning and developing
membership services and programs. Please check the appropriate category.
Job
Function:
o
HR Generalist
o
Recruitment
o
Benefits
o Compensation
o
Labor / Industrial
Relations
o
Training
/ Development
o
Organizational
Development
o
Legal
o
Health, Safety,
Security
o
Employee
Assistance
o
Employee
Relations
o
Communications
o
EEO / Affirmative
Action
o
HRIS
o
Research
o
Consultant
o
Administrative
o
International
o
Other _______ |
Unit
Size:
o
Fewer than 100 employees
o
100-249
o
250-499
o
500-999
o
1000-2499
o
2500-4999
o
5000 and
over
HR Department Size:
o
1-2 employees
o
3-5 employees
o
6-15 employees
o
16-50 employees
o
Over 50 employees
Labor
Structure:
o
Non-Union
o
Union
o
Both
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Business/Industry:
o
Agriculture,
Forestry, Fishing
o
Manufacturing
(Non-Durable)
o
Manufacturing
(Durable Goods)
o
Transportation
o
Utilities
o
Wholesale/Retail
Trade
o
Finance
o
Insurance
o
Services
(Profit)
o
Services
(Non-Profit)
o
Health
o
Real Estate
o
Educational
Services
o
Government
o
Construction
& Mining
o
Oil &
Gas
o
Library
oOther
________
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CHRA COMMITTEES
Committee
Volunteers are the heart of CHRA. To which of these committees would you
be interested in giving your time and energy?
o
College Relations
o
Community
Outreach
o
Compensation
and Benefits
o
Diversity
o
Government
Affairs |
o
Marketing
o
Membership
Development
o
Professional Certification
o
Professional
Development
o
Spring Conference |
o
Volunteer
Development
o
Workforce
Readiness
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Referral:
Please send CHRA membership information to the following:
Name:___________________________________________________________
Company:__________________________ Address:____________________________
City/State/Zip: ______________________________
Payment
Options:
o Check
payable to CHRA
o Charge
to the following credit card: VISA MasterCard AmEx
Card #: ____________________________________________________
Exp. Date: _____________
Signature
of Card Holder _____________________________________________________
I
agree to comply with CHRA's Code
of Ethics.
Applicant's
Signature: _______________________________ Date: ________
Print Name:
_____________________________________
720
Light Street, Baltimore, MD 21230
TEL: (410) 752-3318• FAX: (410) 752-8295
EMAIL:
CHRA@assnhqtrs.com
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