SHRM PRIMARY CHAPTER DESIGNATION CHAPTER 213 SHRM-LI CHAPTER, INC. AREA 1 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 statistical reporting and financial support program purposes only. MEMBERSHIP CLASSIFICATION (See Back) (If Student Check Here___) Society for Human Resource Management LONG ISLAND CHAPTER, INC. Chapter No. 213 – 100% National Chapter Silver Excell Award Winner (2010 & 2011) Federal I.D. # 11-3051329 PROFESSIONAL: ______ GENERAL: ______ ASSOCIATE: ______ NAME______________________________TITLE________________ CERTIFICATION (PHR, SPHR, GPHR, OTHER)__________________ 2015 OFFICERS REPORT TO_________________________TITLE________________ PRESIDENT Christel Colón SPHR, SHRM-SCP Brookhaven National Laboratory President@SHRMLI.org COMPANY_______________________________________________ COMPANY ADDRESS_____________________________________ PRESIDENT ELECT Danielle C. Barry SPHR, SHRM-SCP Sportime Clubs, LLC PresidentElect@SHRMLI.org TREASURER Lisa Dippel, PHR Posillico Treasurer@SHRMLI.org SECRETARY Jennifer Carey SPHR, SHRM-SCP Multi Packaging Solutions Secretary@SHRMLI.org BOARD OF DIRECTORS Robin McConnell Annette Perry PHR, SHRM-CP Robert Potorski Doug Silverman Executive Director/Conference Producer Linda B. Selden-Paduano SHRM-Long Island 449 Pulaski Road Greenlawn, NY 11740 (631) 262-8807 (Phone) (631) 262-8803 (Fax) ExecutiveDirector@shrmli.org (Number and Street) ________________________________________________________ (City, State and Zip Code) PHONE__________________________FAX____________________ E-MAIL ADDRESS________________________________________ MEMBER’S SIGNATURE__________________________________ (Member must sign to validate) MEMBER’S NATIONAL ID NO.____________________________ HOME ADDRESS_________________________________________ (Number and Street) ________________________________________________________ (City, State and Zip Code) HOME PHONE___________________________________________ HOME E-MAIL ADDRESS_________________________________ DATE____________MAIL SHOULD GO TO MY: HOME___OFFICE___ (Please check one) Please give a brief description of the services/products provided by your firm. ______________________________________________________________ ______________________________________________________________ Please return by mail to: or FAX to: (631) 262-8803 Linda B. Selden-Paduano, Executive Director SHRM-Long Island Chapter, Inc. 449 Pulaski Road, Greenlawn, NY 11740 SOCIETY FOR HUMAN RESOURCE MANAGEMENT LONG ISLAND CHAPTER, INC. MEMBERSHIP CLASSIFICATIONS Professional Membership: Individuals who are engaged in the profession of human resource management and who meet one of the following criteria: i. Possess at least three (3) years of exempt-level human resource management experience. ii. Are certified by the Human Resource Certification Institute. iii. Are faculty members holding assistant, associate or full professorial rank in human resource management or any of its specialized functions at an accredited college or university and have at least three (3) years of experience at this level of teaching. iv. Are full-time consultants with at least three (3) years experience as a practitioner in human resource management. v. Are full-time attorneys with at least three (3) years experience in counseling and advising clients on matters relating to the human resource profession. Professional Members may vote and hold office in the SHRM-LI. Professional Members shall be a National Member in good standing and will be responsible for payment of full SHRM dues at the prevailing rate at each annual renewal. General Membership: Individuals who are engaged in the profession of human resource management in an exempt position but do not meet the requirements of Professional Membership. General Members have the right to vote, but may not hold office in the SHRM-LI. General Members shall be a National Member in good standing and will be responsible for payment of full SHRM dues at the prevailing rate at each annual renewal. Associate Membership: Individuals in non-exempt human resource management positions, plus persons who do not meet the qualifications of the other classes of membership, but who are interested in the field of human resource management, or are part of an appropriate governmental or educational service. Associate members, as defined herein, shall not have voting rights, shall not be eligible to hold elective offices, shall be a National Member in good standing, and will be responsible for payment of full SHRM dues at the prevailing rate at each annual renewal. Student Membership: Individuals who hold a SHRM Student Membership can align with the Long Island Chapter to receive many special benefits.