Published by Lake/Sumter
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INSIDE THIS President’s Message
ISSUE April 2010
1 President’s L. Dawn Shovestull,
Conference It’s 2010! Get up, Dress up, and Show up:
6 Membership Small Commitments get BIG Changes
10 LSSHRM General CONGRATULATIONS to Lake Sumter SHRM for achieving the 2009
Membership Superior Merit!
13 LSSHRM Board This special honor recognizes our exceptional support for the Human
Meeting Minutes Resources profession and our community.
16 LSSHRM Officers
Kay Wilson passed the SPHR exam. Whoo Hoo!
17 Committee Chair
17 Upcoming Events HRCI Credits have been approved for the workshop!
2.5 Strategic and 2.5 general for a total of 5 credits.
We have accomplished a lot so far this year. The By-Laws committee
have submitted their recommendations, the Belk Charity Sale was a
huge success, the workshop is just a few days away, 2 of our
upcoming lunch programs have already been approved for HRCI
credits, and did everyone get a chance to hear Mike Metcalf, our Diversity
Chairman on the radio last week?
Next on our list is the STP/ATP nominations to complete for the HR Florida
competition. The winners will be recognized at the HR Florida conference at the
end of August. Have you registered to attend the conference yet?
Thank you everyone for all your hard work and support this year
See you at the workshop.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 2
By Arthur R. “Randy Brown, Jr., Esq.
Health Care Reform Guidance Released by IRS
On April 28, 2010 the Internal Revenue Service (IRS) issued guidance on the
new health care reform law regarding employer-sponsored health plans. Under
the issued guidance employers may provide coverage free from federal income
tax to an employee’s children up to age 27. Dependency and marriage does not
affect this exclusion. This exclusion is effective for health coverage provided on
or after March 30, 2010, and ceases to apply in the year in which the child turns
On Jan. 1, 2011, most calendar-year health plans will need to comply with the
new health care reform mandate to extend coverage to adult children up to age
Health Care Tax Credit for Small Employers
The Patient Protection and Affordable Care Act enacted in March, provides a tax
credit to small employers that pay at least half the cost of single coverage for
their employees in 2010. The credit is targeted to help small businesses and tax-
exempt organizations that employ primarily low- and moderate-income workers.
For tax-years 2010 through 2013, the maximum credit is 35 percent of premiums
paid by eligible small business employers and 25 percent of premiums paid by
eligible employers that are tax-exempt organizations. The maximum credit goes
to small employers—those with 10 or fewer full-time equivalent (FTE)
employees—paying annual average wages of $25,000 or less. The credit is
unavailable to employers that have 25 FTEs or more or that pay average wages
of $50,000 per year or more. Because the eligibility rules are based in part on the
number of FTEs, not the number of employees, businesses that use part-time
help might qualify for some tax advantages even if they employ more than 25
Eligible small businesses can claim the credit as part of the general business
credit starting with the 2010 income tax return they file in 2011.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 3
Health Care Law’s Offers Whistle-Blower Protection
Section 1558 of the Patient Protection and Affordable Care Act amends the Fair
Labor Standards Act to prohibit employers from retaliating against employees
who apply for health benefit subsidies or receive tax credits under the health
reform law. In addition, the law offers protections to employees who provide
information or testimony about possible employer violations of Title I of the law.
Title I establishes the new requirements for businesses and individuals when
purchasing health care insurance.
Under the law, workers must file complaints with the U.S. Occupational Safety
and Health Administration (OSHA) within 180 days of becoming aware of any
retaliatory actions by their employers. OSHA will investigate the claims and can
order preliminary relief, such as reinstatement of an employee. However, if
OSHA fails to resolve a complaint within 210 days or if the Labor Department
fails to act within 90 days of receiving a written determination from OSHA about
possible violations, then the worker who filed the claim can seek relief through a
federal court and request a jury trial.
The remedies available, according to the law, include reinstatement, back pay
with interest, special damages, attorney’s fees, litigation costs and expert witness
CHECK OUT OUR WEBSITE!!!!!
Visit us at: http://lakesumter.shrm.org
LAKE-SUMTER SHRM Newsletter- May 2010 Page 4
Kelly Marcoux, MMC, PHR
2010 Conference Chair
Save the date!!
Lake Sumter SHRM’s Annual Human Resource Conference and
May 26, 2010, 8:30 am- 4:30 pm
Leesburg Community Center at Venetian Gardens
“A New Decade….a New Beginning?”
Register now at http://lakesumter.shrm.org Events page
$65.00 for LSSHRM Members and $85.00 for Non-Members
VENDOR EXPO, DOOR PRIZES, CONTINENTAL BREAKFAST, AND LUNCH
2009 has ended and a new decade has begun. Find out what the experts
have to say about employment trends for the future.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 5
Dorthory Knapp, SPHR – “HR Competencies: Setting the Stage for Future Success”
Dorothy Knapp, SPHR is Field Services Director in the Southeast Region for
SHRM. She has accountability for the states of Alabama, Colorado, Florida,
Georgia, Mississippi, New Mexico and the islands of Bermuda, Bahamas,
Puerto Rico, and St. Croix. Dorothy also serves as the staff liaison to the
Organizational Development panel for SHRM. She heads the Workforce
Readiness Core Leadership Area. She is also a member of the SHRM
Speakers Bureau. Dorothy has been with SHRM for over 10 years, serving in
various management positions. Before joining SHRM, Dorothy was a regional
HR manager in the retail and restaurant industries, having worked for both
Stein Mart and the Black-eyed Pea restaurants. Her HR functions included
employee relations, training and development, and staffing and retention of
managers. Dorothy holds a Master’s Degree in Education and is certified as a
Senior Professional in Human Resources.
Arthur R. “Randy” Brown, Esq. - “Proceed With Caution-When Re-hiring Laid Off
Employees” Arthur R. “Randy” Brown, Jr. is a solo practitioner in Mount Dora, Florida.
He is a Board Certified Specialist in Labor and Employment Law, and
Certified Civil Circuit Mediator. He earned a Bachelor of Arts degree from
the University of Miami, and received his Juris Doctor degree from Whittier
College School of Law. His practice involves all areas related to labor and
employment. Mr. Brown presently serves as Legislative Chair for the Lake
Sumter SHRM, Inc. and has been beneficial in our chapter winning the
coveted STP/ADP award for legislation two years in a row.
Dr. Jeff Ling – Evergreen Solutions “How Will We Reward in the Future”
Dr. Jeffrey Ling is Executive Vice President of Evergreen Solutions, LLC and
the director for the firm's human capital and state/local government practice
area. In his professional work, he has interacted with over 400 clients from
around the world, focusing on human resources solutions, operational
efficiency and effectiveness, information technology implementation, strategic
planning, and business process management. He taught public management at
the College of Wooster, Florida State University, and Iowa State University.
developing worked in the consulting field for
more than 18 years,Dr. Ling hashighly successful consulting practices targeted at education,
state, and local government markets. In addition, Dr. Ling has been a guess speaker for many
states, local and regional meetings, including for the Florida Public Personnel Association,
National Association of State Personnel Executives, Kansas Public Personnel Conference, and
the Texas County Leadership Institute.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 6
Gerry Hoeffner – “Beyond This Point There Be Dragons,” Managing Dynamic
Change in the workplace
Gerry Hoeffner's presentations are energizing employees,
corporations, civic groups and business organizations throughout
the United States
Gerry Hoeffner is President of Personnel Dynamics Consulting
Group, which specializes in Change Management, Corporate
Culture Enhancement, and Employee Development.
Gerry has two decades of employee development experience and
has found a unique and energizing approach to training employees
and their management teams. Gerry's experience in manufacturing, retail sales, financial
services, and the medical field provides a broad spectrum of insight and knowledge to his
work. Gerry travels throughout the U.S. speaking on issues involving business and the
human element. He supplies educational and consulting services to managers, owners and
employees aimed at implementing change and improving the performance of their teams.
HR magazine called his work on the Workforce 2020 program "the most effective part of
the day". In 2002, his “Best Places to Work” program was the recipient of the Pinnacle
Award from the National Society for Human Resource Management (SHRM) for the St.
Lucie County Human Resources Association. Gerry's energy and humor has made him a
popular addition to conferences throughout the United States.
5 Credit Hours Pending
"The use of this seal is not an endorsement by HR Certification Institute of the quality of the program. It means that this program has
met HR Certification Institute’s criteria to be pre-approved for recertification credit."
By Marge E. Strausbaugh, MMC, CPM
President Elect/Membership Chair
By now members should have been emailed a set of proposed Lake Sumter SHRM
Bylaw changes. If you have not seen the proposed changes they can be reviewed on the
LAKE-SUMTER SHRM Newsletter- May 2010 Page 7
Lake Sumter SHRM web site. Or, email me at firstname.lastname@example.org and I will
forward the proposed changes to you.
A main objective in the proposed changes is to better align and define our core
membership of Human Resource Professionals as one professional group, defined equally
by the fact that the Professional category of members work at the 50% or higher level in
the Human Resource profession. We also welcome those members (Associate and
Student) that work with the Human Resource profession even though it may not be their
main focus. These changes should open our membership up to those in offices and
workforces that may do some Human Resources, without working at the 50% level. What
better place to get the help needed then from our Lake Sumter SHRM! These changes
should better promote and help our Chapter grow.
We incorporated into the bylaws the mission, vision and ethical code documents that
were created from the strategic planning session held last year. Our corporate name is
Lake Sumter Society for Human Resource Management, Inc. Therefore, we also changed
in the bylaws, the shortened version of the corporate name to the Lake Sumter SHRM
name (rather than LSSHRM). Lake Sumter SHRM more clearly defines who and what
our Chapter is all about, while giving our chapter a shortened version of the corporate
Join SHRM National:
SHRM is currently discounting the membership for first time members. What better time
to join, if you have never been a member of the National Society for Human Resource
Management team. SHRM is an invaluable resource of help for the Human Resource
profession and for the many working in that profession. From forms, to articles, to
webinars, to data and information to finding the answer to a question that will better help
you do your job; it’s all there and available for SHRM members. Most importantly, that
information is only a “click” away to the SHRM website at www.shrm.com
HR Florida 2010 Conference & Expo August 30 – September 1, 2010
The HR Florida 2010 Conference & Expo will be held at the Rosen Shingle
Creek Resort in Orlando, FL.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 8
LAKE-SUMTER SHRM is holding the annual
Membership Drive Contest
LET THE GAMES BEGIN!!!!!
Lake-Sumter SHRM Membership Drive Contest is in process and ends May 31, 2010.
Share Lake-Sumter SHRM with everyone you know. The member that brings in the most
new members wins a grand prize which is a free registration to HR FLORIDA
CONFERENCE & EXPO in August. This is a $500.00 value. The results will be
tabulated at the June Board Meeting, and the winner will be announced at the June 23rd
Membership meeting. So get busy and WIN.
“LSSHRM Membership drive is on NOW and ends May 31,
2010…Get busy and WIN.”
Join SHRM at a Special Discounted Rate!
New, first-time members to SHRM can join online using the
promotional code CHSED for a reduced rate of $145.
That’s only about 39 cents a day!
Go to www.shrm.org/join and enter the code
into the promotional code space on the application.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 9
Go online: Complete: Or:
The online enrollment form and be Call our Member Care Center at:
Click: sure to enter this promotional code (800) 283-SHRM (United States)
Join/Renew in the box indicated TTY/TDD (703) 548-6999
SHRM Foundation News:
The Masters Series at the SHRM Annual Conference Sponsored by the SHRM
Foundation for the 16th year, the Master Series during the SHRM Annual Conference is a
series of senior-level programs (open to all conference attendees) that offer insight into
the HR profession from thought-leaders and top academicians. These in-depth learning
sessions feature internationally known experts in the field of management science, with a
focus on timely and provocative issues that affect your career and industry.
The 2010 Masters Series will feature Dr. Iris Firstenberg speaking about "Innovation in
Turbulent Times"; Dr. Fons Trompeanaars discussing "Cross-Cultural Dimensions of
Mergers and Acquisitions"; and Dr. Michael Beer talking on "How to Build a Resilient
Organization for Sustained Advantage."
For more information on Foundation-sponsored educational programs, visit the SHRM
Foundation website (www.shrm.org/foundation).
CHECK OUT OUR WEBSITE!!!!!
Visit us at: http://lakesumter.shrm.org
LAKE-SUMTER SHRM Newsletter- May 2010 Page 10
20 years of service!
Apr. 28, 2010
Leesburg Comm. Center
Lunch and networking was provided from 11:30 – 12:00 in the West Room at the
Leesburg Community Center
Bender Bruce Tri-State Employment McKeeby Kathy Trust Co Bank
Bowers Scott Lassiter Ware/ Speaker Metcalf Mike Cornerstone Hospice
Brasher Brenda Howey in the Hills Moberg Katie Spherion Staffing
Carver Paula Minneola Mohrenne Rona Lowe’s
Childers Doug Lassiter-Ware Palmer Elizabeth Fruitland Park
Fairgrieve Cindy HarborPoint Media Pike Judy Langley Medical
Fields Kitty BOCC/HR Florida President Rigdon Stacey City of Umatilla
Fontaine Debbie Silver Springs Citrus Sanna Cheryl
Golbert Robert Spherion Staffing Shovestull Dawn Restore Telecom
Goshorn Dawn American Cement Co Singleton Les Pre-Paid Legal
Gonzales Luisa Townsend Tera Lassiter-Ware
Hall Linda Community Foundation of S. Lake Weazel Patti LSCC
Higdon Christie Groveland Wilson Kay Citrus Cardiology
Howard Karen City of Umatilla
Hughes Kristen Lassiter-Ware Bannister/Cooper Student Chaperones
Hunt Shelley BOCC Bannister K’yal Student Speaker
Kennedy Gail Cornerstone Hospice Childers Sr Doug Guest of Doug Childers
Kropp Jeff Suddath Relocation Ireland Dutch Guest of Cheryl Sanna
Marcoux Kelly City of Bushnell
LAKE-SUMTER SHRM Newsletter- May 2010 Page 11
During lunch, student K’Yal Bannister gave her speech. Student involvement during our
monthly meetings is part of our Workforce Readiness program this year. She was well
received by her audience.
CALL TO ORDER:
The membership meeting of the Lake Sumter Society for Human Resource Management,
Inc. was called to order by Dawn Shovestull, President, on April 28, 2010 at 12:15 PM.
No introductions were made today.
Upon motion by Kelly Marcoux and seconded by Scott Bowers, the minutes of the
General Meeting of March 24, 2010 were unanimously approved.
Upon motion by Debbie Fontaine and seconded by Kitty Fields, the Treasurer’s Report
for March 2010 was unanimously approved. Opening balance was $4,297.92 and the
ending balance was $7,223.97; and there is $454.77 in our savings account.
Membership – Dawn Shovestull announced the new members: Elizabeth Palmer (City
of Fruitland Park), Judy McKenzie (Mission Inn), Malyssa Goldsmith (Lake County
Clerk of Courts), and Dawn Goshorn (American Cement Company). Dawn also
reminded the membership of the Membership Drive and of the contest for bringing in the
most new members through the end of May. The winner will receive an HR Florida
Programs – Kay Wilson reported that we have a full schedule for this year and that
many of our programs have already been approved for HRCI credit, 12 general credits
and 2 strategic credits. The month of November is still open.
Certification – Scott Bowers reported that the certification class has successfully
completed the session. There will be two individuals taking the exam.
Diversity – Mike Metcalf said that he attended the April 7th Core Leadership conference
call regarding the transition of veterans into the workforce. He encouraged everyone to
read the newsletter. He also distributed a handout titled, “ Tanenbaum Launches Online
Guide to Help Employers Navigate Workplace Diversity Issues”.
Workforce Readiness – Kelly Marcoux thanked the student speaker who addressed
the membership during lunch. There will also be student moderators at our May
conference. Kelly also reported that 26 students participated in a tour of the facilities of
the City of Bushnell, Langley Medical Center and SECO. Employees of those employers
LAKE-SUMTER SHRM Newsletter- May 2010 Page 12
spoke to the students about their positions and the qualifications needed to obtain those
positions. There will be another group of students scheduled in May.
Legislative – No report, but please read Randy Brown’s article in the April newsletter.
Communications – No report, but please the April newsletter available on the website.
Foundation – Rona Mohrenne passed the container for donations and also encouraged
contributions from employers. She indicated that the Foundation will be represented at
the upcoming conference and there will be a 50/50 drawing and jewelry available for
auction in order to raise funds for the SHRM Foundation. Linda Hall reported on the
upcoming Belk Charity Sale in which we are selling $5.00 tickets to raise funds for the
Foundation. Linda, Cindy Fairgrieve and Luisa Gonzales will be “manning” the table at
the store on the day of the event, May 1st in order to add to our fundraising total. We
have done well with this event in the past and hope to do as well this time.
Technology – Kathy McKeeby reported that SHRM will be revamping on our new
website, but hopes there will be minimal interruption. Please visit us at
Community Relations – No report, but Dawn encouraged all members to attend the
upcoming Leesburg Chamber meetings, 4th Thursday of each month.
Conference – Kelly Marcoux reported that 4 speakers have been arranged for the
conference. We are also sponsoring a contest with two winners – one for the most
sponsors obtained for the conference, and one for the most dollars obtained from
sponsors. Prizes awarded will be HR FL registrations. We have met our goal for
sponsors, but still encourage additional. Please promote our conference to those you
know and would benefit from the knowledge that will be shared. We have a May 10th
deadline for registration.
Hospitality – No report.
HR Florida Ambassador – Kitty Fields reported the HR Florida Conference is
scheduled for August 30 – September 1st. May 1 the registration fee increases.
“The Role of HR in Workers Compensation” Presented by Scott Bowers, SPHR
Upon motion made by Debbie Fontaine and seconded by Katie Moberg, it was
unanimously approved to adjourn the meeting at 1:30 PM.
Cynthia S. Fairgrieve, PHR, Secretary
LAKE-SUMTER SHRM Newsletter- May 2010 Page 13
20 years of service!
May 12, 2010
Room 116, Health Science Center
Dawn Shovestull, Cindy Fairgrieve, Michelle Hawkins, Debbie Fontaine, Rona
Mohrenne, Diane Gibson Smith, Mike Metcalf, Patti Weasel, and Kelly Marcoux.
CALL TO ORDER:
Dawn Shovestull, President, called the meeting to order at 3:25 PM at the LSCC Health
Science Center Room 116.
Reading of the minutes of the April 14, 2010 Board Meeting were waived until the next
Board meeting. However, the minutes were included in the April 2010 newsletter.
Upon motion by Mike Metcalf and seconded by Patti Weasel, the April 2010 Treasurer’s
Report was unanimously approved. Beginning balance $7,223.97 and ending balance
$7,818.51. The savings account has a balance of $454.77.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 14
Marge Strausbaugh and the By-Laws committee members have completed the review of
the current Chapter By-Laws and made necessary updates. Marge will be sending a copy
to all current Board members for final review. Approval is scheduled for the June
Dawn stressed that the STP/ATP Award applications were due to SHRM in June, and
that she would like to review before the deadline. Please complete your section and send
to Dawn for review before June 5th.
On April 21, 2010 Marge Strausbaugh made a motion to accept Elizabeth Palmer as a
Professional member, seconded by Diane Gibson Smith. Via email voting between April
21 and April 23, the Board approved Elizabeth Palmer for Professional membership.
Kelly will direct discussion regarding the details of the HR conference later in this
Kelly Marcoux requested that the Board approve a $50 donation to the SHRM
Foundation in memory of Scott Bowers’ stepfather, Fred Bartone. The members of the
Board voted via email and approved the donation.
No new business during this meeting.
Membership – We received a membership applications for Rebecca Frost from Brown
& Brown Insurance and reviewed once again the application of Devi Drexler of LSCC..
Kelly Marcoux made a motion that Rebecca be approved for Professional membership,
Diane Gibson Smith seconded, and motion passed.
Diane Gibson Smith made a motion that Devi be approved for associate membership,
with a possible change to Professional when her resume is received for further review by
the Board members. Kelly Marcoux seconded the motion. Motion passed.
Dawn will inform Marge to contact our new members.
Programs – Dawn reported that the strategic credits for one of the programs for the
conference are being held up due to the request for additional information. Dawn and
Kay have supplied the required information, and we are waiting for the HRCI response.
Dawn also reported that the program for the month of November has now been planned.
There will be a program concerning Affirmative Action. The program has been
submitted for HRCI credit.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 15
Certification – Dawn reported that the class for this session has completed for the
Diversity – Mike Metcalf said that he will be on the radio, 570 AM, Friday, May 14,
2010, at 11:30 AM to promote Diversity.
Workforce Readiness – Kelly Marcoux said that there will be student speakers at the
May conference. Patti Weasel is working several programs at LSCC involving high
school seniors, enabling them to have a smooth transition to college level classes/life.
Legislative – No report. Please read the May newsletter article.
Communications – Michelle Hawkins said the newsletter deadline is Friday.
Foundation – Rona reported that we took part in the Belk Charity sale on May 1st from
6 AM to 10 AM to raise funds for the SHRM Foundation. Linda Hall was not in
attendance to report the final results. Rona also reported that she took part in the SHRM
conference call for Foundation fundraising.
Technology – No report. Please visit us at http://lakesumter.shrm.org.
Community Relations – No report
Hospitality - No report.
At Large - No report.
HR Florida Ambassador – No report
Conference – Kelly Marcoux reported we have 73 registrations and one new sponsor.
Unfortunately one vendor had to back out. There will be no keypads used this year, and
paper evaluations will be distributed at the time of registration.
Debra Davis Catering has given us a price of $12.00 per person for the food being served
on the day of the Conference.
Many of the other details were discussed at length.
There will be a Conference bag stuffing on Monday May 24, 2010 at 5:30 PM to be
held at Restor Telecom conference room, Building 915. Any last minute details will
also be discussed.
Conference Committee members are requested to be at the conference site at 7:30 AM to
assist in the set up.
LAKE-SUMTER SHRM Newsletter- May 2010 Page 16
Upon motion made by Debbie Fontaine and seconded by Rona Mohrenne, it was
unanimously approved to adjourn the meeting at 5:05 PM.
Cynthia S. Fairgrieve, PHR
CHECK OUT OUR WEBSITE!!!!!
Visit us at: http://lakesumter.shrm.org
2010 LAKE-SUMTER SHRM
President: Laurinda “Dawn” Shovestull, PHR 352-314-0144
Marge Strausbaugh, MMC, CPM
Kay Wilson, PHR 352-330-4811
Secretary: Cynthia Fairgrieve, PHR 352-365-8217
Treasurer: Dianne Gibson-Smith 352-360-6727
Past President: Kelly M. Marcoux, MMC, PHR 352-793-2591
LAKE-SUMTER SHRM Newsletter- May 2010 Page 17
2010 LAKE-SUMTER SHRM
Membership Chair Marge Strausbaugh, MMC, CPM
Programs Chair M. Kay Wilson, PHR
Certification Chair Eric “Scott” Bowers, SPHR
Certification Co-Chair Sandy Zeljko, PhD
Diversity Chair Mike Metcalf
Workforce Readiness Chair Andrea Zito
Legislative Chair Arthur R. “Randy” Brown, Jr., Esq.
Newsletter Chair Michelle Hawkins
Technology/Web Site Chair Kathy McKeeby, PHR
Foundation Chair Rona Mohrenne, PHR
Conference Chair Kelly Marcoux, MMC, PHR
Community Relations Chair Kathy McKeeby, PHR
Hospitality Chair Elaine C. Pelton
HR Florida Ambassador Elaine C. Pelton
Scholarship Chair Marge Strausbaugh, MMC, CPM
LSSHRM At-Large Director Kitty L. Fields, PHR
Bonnie Pineda, PHR
Lake-Sumter SHRM Annual Conference- May 26, 2010
Lake-Sumter SHRM Board Meeting- June 9, 2010
CHECK OUT OUR WEBSITE!!!!!
Visit us at: http://lakesumter.shrm.org
LAKE-SUMTER SHRM Newsletter- May 2010 Page 18
Please complete and return with your ues payment. Annual LAKE SUMTER
SHRM dues are $30.00. National SHRM members may choose to take a discount of
$5.00 resulting in annual dues of $25.00. Please make the check payable to: LAKE
SUMTER SHRM, Inc.
Mail to: LAKE-SUMTER SHRM, Inc.
PO Box 490003
Leesburg, Fl 34749-0003
SHRM Member No.:
Dues amount submitting:
Lunches (11 maximum) at $10.00 each
Total amount submitting:
Preference for vegetarian (circle one): Yes or No
Please check any of the following that apply:
□ SHRM Member □ SPHR Certified □ Other certification:
□ PHR Certified □ GPHR Certified Type: