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Primary Chapter Designation Form 

04-04-2016 18:31

Form for SHRM at-large members to use to designate their primary local SHRM-affiliated chapter.

SHRM Primary Chapter Designation
Submission Deadlines and Sample Form

While a SHRM member may belong to more than one affiliated chapter, only one chapter may be designated as that member's primary chapter. The member is free to change that designation as he/she wishes. Primary Chapter Designation Forms (CDFs) are signed directives from the member to SHRM authorizing SHRM to change his/her primary chapter deisgnation.

The CDF is completed by the member and FAXed to SHRM at the specified number. Upon receipt of the executed form, the member's primary chapter will be changed. To ensure changes are made during the appropriate month, submission deadlines are in place.

From January through November, the signed form must be received by the 5th business day prior to the end of the month to be processed in that month.

For the month of December, the signed form must be received by the 15th of the month to be processed by December 31st.

Forms received after the deadlines will be held for processing in the following month.

Download a Primary Chapter Designation Form Template

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Sample Primary Chapter Designation Form

Chapter #__________ Chapter Name_____________________________

I hereby designate the above named chapter as my primary chapter for SHRM membership coding purposes. I understand that:

  1. This in no way precludes membership in other chapters.
  2. This allows SHRM to list my membership to this chapter for financial support program purposes only.
Please type or print:

NAME____________________________________ SHRM MEMBER ID#_____________
(You must be a current national member of the Society for Human Resource Management to complete this form.)

COMPANY NAME___________________________________________________




PHONE# ___________________________________________

FAX ________________________________________________________

E-MAIL _____________________________________________________

DATE ____ MEMBER'S SIGNATURE__________________________
  (Member must sign to validate)

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