Membership Application

On this day, I hereby make request that my name be brought before the members of the Wayne County Human Resources Association for the purpose of considering my application to be received as a Regular Member of said Association based on my personal qualifications and the qualifications of my employer. I submit the following information as indication of my bona fide interest in the affairs of the WCHRA :

Your Name:

Referred By:

Name of Employer:

Subsidiary/Affiliate of:

Business Mailing Address:

City/State/Zip:

Business Phone Number/Fax Number:

Email Address:

Sponsored/Referred By:

Nature of Business:

My present responsibilities with the above stated employer as it relates to human resource management are:

I spend approximately % of my time relating to the above stated responsibilities.

What area of expertise can you bring to the WCHRA?:

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