Member Application

Please fill out the following information in order to become a member.

Account Information

* E-Mail Address

Title (Mr/Ms/Dr.)

* First Name

* Last Name

Suffix (Sr, Jr, II, III)

Nick/Screen Name

Your Birthday (12/31/1999)

Your Website

* Address

Address Cont.

* City/Town

* State

* Postal Code

Phone

Mobile

Alternate E-Mail

IM Handle

Professional Information

* Organization

Are you self employed?

* Your Title

Website (Start With: "http://")

How Many Locations Does Your Company Have?

Only 1 Location in NC
Multiple Locations in NC
Multiple Locations in the US
International

* Company Overall Size

* What Is The Size Of Your HR Department

* Address

Address Cont.

* City/Town

* Country

* State

Postal Code

Phone

* SHRM Member

SHRM Membership Number

HR Certified

Current Certification (Indicate all current HR Certifications)

Additional Information

Chapter CLA Role

* LKNHR Primary Chapter Designation Would you like to designate Lake Norman HR as your home chapter?

Yes
No

Local Chapter

More Information

Education/Experience

Social/Volunteer Organizations

How Did You Learn about Lake Norman HR?

* Choose The Level of Membership You Are Applying For? This will help select level of membership to charge.

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