Membership Application

Membership Year

Select which membership year this application is for

Is this a new member application or a renewal of a current membership?*

Membership dates are from January 1st to December 31st.

New
Renewal

About You

Name*

Note: For corporate membership, this should be the name of the person responsible for the corporate membership. Additional names may be added in another section below.

First Last

Job Title*

Name of business or organization*

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Are you a member of national SHRM?*

Yes
No

Please provide the email address you use with your SHRM membership*

This is used for LAHRA chapter reporting purposes only.

Do you currently hold any HR Certifications?

Yes
No

Check all certifications that apply.*

SHRM-CP
SHRM-SCP
PHR
SPHR
GPHR
Other

Member directory

If you'd like your contact information to be displayed in the online member directory, please check the box below:

Yes, I want to display my contact information in the member directory

Membership

LAHRA Membership Type*

Please select the type of membership for which you are applying or renewing. Annual membership is for the year beginning January 1st through December 31st. For questions about membership, please contact Jennifer Slater, Membership Chair at (248) 770-2172 or Membership @LivingstonHR.org

Corporate Rate (up to 5 total members): $125
Individual Rate: $65
SHRM Rate: $55
Student Rate: $10

What college/university do you currently attend?*

What year do you anticipate graduating?*

Additional corporate members

Please enter up to 4 additional members for your corporate membership

First Name	Last Name	Title	HR Certifications (list, if applicable)	Email	National SHRM Member? (Y/N)	Email used with SHRM Membership (if different)	LAHRA Use Only (business/org)

How did you hear about us?

Facebook
LinkedIn
SHRM or MISHRM
LAHRA Website
LAHRA Email
Current LAHRA Member
Other

Name of current LAHRA member who referred you:

Opportunities through your LAHRA Membership

Committee/Volunteer Participation

Are you curious about participating on a committee or volunteering with LAHRA? Check any of these opportunities and a board member will contact you!

Programs
Membership
Communications/Social Media
Other

Leadership Positions

If you're interested in volunteering for or learning more about any of these core leadership positions, please select your area(s) of interest and a LAHRA board member will contact you!

Diversity/Inclusion
HR Certification
Programs
SHRM Foundation
Workforce Readiness
Other

Notes

Please enter any other information you'd like to share about your volunteer interests.

Sponsorship Opportunities

If your organization is interested in learning more about 2021 LAHRA sponsorship opportunities (website, programs, etc.), please check this box and we will contact you.

Yes, please contact me about sponsorship

Payment

Payment for membership may be made by credit card via PayPal. Corporate and Individual memberships will be enrolled in an auto renewal annual subscription plan. The auto renewal can be cancelled in PayPal at any time if you wish to opt out.

As a national SHRM Student Member, you are eligible for free LAHRA membership as long as you have provided us with the email address you use with your SHRM membership in the space above. Please enter the coupon code 2022SHRMSTUDENT in the coupon code field below to remove the $10 cost of LAHRA Student membership.

Corporate memberships may be paid by credit card or by check. If you prefer to pay by check, please enter 2022PAYBYCHECK in the coupon code field below, make your check payable to LAHRA, and mail it to LAHRA, P.O. Box 2277, Howell, MI 48844. Membership will become active when payment is received.

Coupon Code

Total

$0.00

LAHRA Privacy Statement*

It is the policy of the Livingston Area Human Resources Association to treat its members' personal information, including all contact information, privately. We will not sell, license or otherwise share or distribute member information with outside parties unless otherwise agreed to by the member(s) in question. By selecting "Yes", you agree to the LAHRA Privacy Statement.

Yes, I agree

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