NEPA SHRM Membership Referral Form

Membership Referral

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You must be a member in good standing to submit a NEW Member referral.
The referral must join NEPA SHRM within 30 days of completion of the form.
The referral must not have been a NEPA SHRM member within the prior 12 consecutive months.

Member Name (First and Last): * *

Member Email (email that is registered with SHRM) * *

Member Telephone * *

Member Employer * *

Referral Name (First and Last): * *

Referral Email * *

Referral Telephone * *

Referral Employer * *

Please Confirm you are a current SHRM and NEPA SHRM Member in Good Stranding? * Yes No

Sign (sign here by typing your name) * *

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