2001-2002
STUDENT
MEMBERSHIP
APPLICATION

Return completed application to:

SHRM Student Services
1800 Duke Street
Alexandria, Virginia 22314-3499 USA

(703) 548-3440 FAX: (703) 739-0399
TDD: (703) 548-6999
E-MAIL: SHRMstudent@shrm.org

EDUCATION & EMPLOYMENT

Academic Major:

Year In School:

Freshman Sophomore Junior
Senior Masters Ph.D.

Estimated Graduation Date (month/year):
Number of hours for which you are currently registered:

Students enrolled in 6-8 credit hours MUST attach a copy of a current course schedule to qualify for membership.

Is your school on a semester quarter compressed
system or other (please explain) ?

Employment Status:
U Not employed in a regular full-time position
N Employed in a full-time non-exempt** (hourly) position
X Employed in a full-time exempt** position
E U.S. Military active duty - Enlisted
O U.S. Military active duty - Commissioned Officer
_{**as defined by the Fair Labor Standards Act (FLSA)}

MEMBERSHIP DUES

Please check the appropriate box.

	1 Year National Student Membership ($35)
	1 Year National Student Membership and student membership in the SHRM Global Forum ($55)
NOTE: Payment must accompany application.
Please indicate method of payment.
	Check or money-order enclosed (US $/US bank only) ^{Payable to SHRM Student Services. DO NOT SEND CASH.}
	Charge my: Visa MasterCard American Express I authorize SHRM to charge my credit card $ Credit Card #: Exp. Date: / Daytime Phone #: Name: ^{(as it appears on credit card)}

SHRM annual dues are not deductible as charitable contributions for federal income tax purposes but may be deductible as ordinary and necessary business expenses except that, under IRC section 162(e)(I), 6.3% of the SHRM annual dues are not deductible. SHRM membership is not transferable.

I hereby apply for student membership in SHRM and agree to pay the current applicable membership dues. I will abide by the SHRM Code of Ethical and Professional Standards in Human Resource Management as detailed online at http://www.shrm.org/ethics.

^{E-Signature/Date}

^{SHRM Chapter Advisor's E-Mail Address}
If no active SHRM chapter exists on your campus, please obtain the e-mail address of your academic advisor or other school official to verify your student status. This is required for acceptance of membership.

MEMBER INFORMATION

New Renewal - Membership # if known
Name
College/University
SS# Chapter #
^{(For internal database ID purposes only)}
If employed in a permanent full-time position, please provide your business address, including your title and company name, and your home address. All other applicants, provide your current mailing address while atteneding school and your permanent home address.

This is my Address at School
Business Address

DO NOT PROVIDE YOUR
COLLGE'S ADDRESS.

SEND MAIL HERE

Title: Co. Name: Address 1:
Address 2:		Apt. #:
City: Zip Code:	State/Province:
Country:
Phone #:	Fax #:
E-mail:

Permanent or Home Address

SEND MAIL HERE

Street:		Apt. #:
City: Zip Code:	State/Province: Phone #:
Country:
E-mail:

Student Membership includes four issues of the Echoes newsletter: two printed and two e-mail issues.

	I DO NOT want to receive student newsletters via e-mail. By checking this box I understand I will receive only two printed issues of Echoes per year via US mail.
	I do not wish to receive non-association mail.

DEMOGRAPHIC INFORMATION

The completion of the following is optional. SHRM maintains this data for use in tracking its membership diversity and in developing additional programs and services.

Birth Date:		Gender: Male Female
Race/Ethnic Identification:
	1 American Indian/Alaskan Native 2 Asian/Pacific Islander 3 Black		4 Hispanic 5 White 6 Other

For SHRM Internal Use Only

Payment received ___________________
Amount $ _________________________
Co. Ck. __________________________
SHRM ___________________________

Pers Ck. _______________________
M.O. __________________________
Chap. Ck. ______________________
Global _________________________

Please allow 4-6 weeks for processing.