INVOICE PO Box Hattiesburg MS Date _______________ Company Name by evanbogart

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									                                                                                         INVOICE
PO Box 15666 Hattiesburg, MS 39404

                                                                                         Date: _______________

Company Name: ____________________________________                                       Invoice #: ONLINE
                                                                                         For: Membership Dues
Address: ____________________________________________________                            2008

City: _________________________            State: _______ Zip: ____________        Telephone: ____________________



 Description                                                                                          Amount
                                       Please Choose One of the following Options:

Single Membership                                           $35.00                                   ___________

Corporate Level One (entitled to three memberships)         $70.00                                   ___________

Corporate Level Two (entitled to six or more memberships)   $140.00                                  ___________




                                                Make all checks payable to:
                                                      South MS SHRM
                                                  Attn: Membership 2008
                                                       PO BOX 15666
                                                   Hattiesburg, MS 39404

       If you have any questions regarding this invoice, please contact Jan Lennon or Kyle Jones at 601-450-3566.

               Thank you for your continued membership! We look forward to seeing you at the meetings!

__________________________________________________________________________________________________
                 Please return this portion, including member information, with your payment.


Company Name: __________________________________________                                        Invoice #: ONLINE

Address: ____________________________________________________

City: _________________________            State: _______ Zip: ____________        Telephone: ____________________


Main Company Contact: ________________________________

                                                                      TOTAL AMOUNT PAID: ____________________
                                              MEMBER INFORMATION

Name: ___________________________________________                     Title: _________________________________________

Email address: _____________________________________________________

Member of National SHRM? YES ____ No____                               PHR ____         SPHR ____
____________________________________________________________________________________________________________________________________


Name: ___________________________________________                     Title: _________________________________________

Email address: _____________________________________________________

Member of National SHRM? YES ____ No____                              PHR ____          SPHR ____

____________________________________________________________________________________________________________________________________


Name: ___________________________________________                     Title: _________________________________________

Email address: _____________________________________________________

Member of National SHRM? YES ____ No____                              PHR ____          SPHR ____

____________________________________________________________________________________________________________________________________


Name: ___________________________________________                     Title: _________________________________________

Email address: _____________________________________________________

Member of National SHRM? YES ____ No____                              PHR ____          SPHR ____

____________________________________________________________________________________________________________________________________


Name: ___________________________________________                     Title: _________________________________________

Email address: _____________________________________________________

Member of National SHRM? YES ____ No____                              PHR ____          SPHR ____

____________________________________________________________________________________________________________________________________


Name: ___________________________________________                     Title: _________________________________________

Email address: _____________________________________________________

Member of National SHRM? YES ____ No____                              PHR ____          SPHR ____

								
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