Submit an Application to Join MAHRA

First Name

Last Name

Company Name

Title or Position

Nature of Business

Street Address

City

State

Zip Code

Work Phone (555)555-5555

Email Address

Fax (555)555-5555

To whom do you report? Title Only

Total Years of HR Experience

Are you certified?

If yes, what is your certification?

Are you presently a member of SHRM?

If yes, SHRM membership number:

Are you? (check all that apply) THIS FIELD IS REQUIRED!

Full-Time

Part-Time

Student

Exempt

Non-exempt

Please check each function you administer as a human resources professional. Do NOT check those functions you perform only as a manager/supervisor

Wage & Salary Administration

Position Evaluation

Benefits Administration

Training/Development

Safety/Health

Labor Relations

Manpower Planning

Interviewing/Recruiting

EEO/AAP

Policies & Procedures

Record Keeping

Employee Assistance

On average, what percentage of your time is spent performing the above functions:

How did you learn about membership in MAHRA?

If referred by a current member, please indicate whom:

NOTE: Please Print this Page before submitting your application for your records