Student Application

First Name *

Last Name *

Job Title

Company Name

Address *

City, State, Zip *

Phone Number *

Certification

Examples: SHRM-CP, SHRM-SCP, PHR, SPHR, GPHR.

SHRM Membership Expiration Date *

Month

Day

Year

When does your SHRM membership expire?

WSU Student Member W Number *

The W number that Weber State University assigned you. Or, if you attend a different school, your school name.

SHRM National Member Email *

The email address you used to register with SHRM.

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