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* 1. First Name

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* 2. Last Name

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* 3. Company

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* 4. Title

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* 5. Email

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* 6. Phone

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* 7. I am a current PHRA Member?

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* 8. If elected, I understand I must join or renew my PHRA membership for the duration of my term.

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* 9. I am a current SHRM Member?

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* 10. If elected, I understand I must join SHRM or renew my SHRM membership for the duration of my term.

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* 11. I am an active PHRA committee volunteer?

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* 12. If elected, I understand I must be an active PHRA committee volunteer.

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* 13. Please tell us why you are interested in becoming a PHRA Board member?

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* 14. Additional Comments:

Thank you for your response! A member from the PHRA Nominating Committee will be in touch. 

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