BSHRM Membership Form New
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Bangladesh Society for Human Resource Management – (BSHRM) Registration No: S-2657(70)/2001 MEMBERSHIP APPLICATION FORM PLEASE WRITE ALL INFORMATION REQUESTED BELOW IN BLOCK LETTERS AND MARK ‘N/A’ WHICH ARE NOT APPLICABLE FOR YOU. MEMBERSHIP INFORMATION (Please tick one) Category Student General Associate Fellow Life Fellow Adm. Fee – Tk 800 Adm. Fee – Tk 1,000 Adm. Fee – Tk 1,500 Adm. Fee – Tk 2,000 One time- Tk 5,000 Annual Fee -Tk 600 Annual Fee- Tk 1,200 Annual Fee -Tk 1,800 Annual Fee- Tk 2,400 Annual Fee- N/A PRIMARY INFORMATION First Name Last Name Middle Name Employer’s Name Designation Nature of Business (For Profit/ Not For Profit) Specific Name of Business (Telecom, Banking, Real Estate, Garments etc.) Years of experience with People Management Pure HR: Other fields: CONTACT INFORMATION Contact Address (Office) Apartment / House # Road Name/ Number City Postal Code Country Contact Address (Residence) Apartment/ House # Road Name/ Number City Postal Code Country Cell Phone(s) Home Phone (For Office Use only): Registration Serial No: Membership No: Please attach one copy recent passport size photo
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Transcript of BSHRM Membership Form New
Bangladesh Society for Human Resource Management (BSHRM)
Registration No: S-2657(70)/2001
MEMBERSHIP APPLICATION FORM
PLEASE WRITE ALL INFORMATION REQUESTED BELOW IN BLOCK LETTERS AND MARK N/A WHICH ARE NOT APPLICABLE FOR YOU.
MEMBERSHIP INFORMATION (Please tick one)
Category Student General Associate Fellow Life Fellow
Adm. Fee Tk 800 Adm. Fee Tk 1,000 Adm. Fee Tk 1,500 Adm. Fee Tk 2,000 One time- Tk 5,000
Annual Fee -Tk 600 Annual Fee- Tk 1,200 Annual Fee -Tk 1,800 Annual Fee- Tk 2,400 Annual Fee- N/A
PRIMARY INFORMATION
First Name
Last Name
Middle Name
Employers Name
Designation
Nature of Business (For Profit/ Not For Profit)
Specific Name of Business (Telecom, Banking, Real Estate, Garments etc.)
Years of experience with People Management
Pure HR:
Other fields:
CONTACT INFORMATION
Contact Address (Office)
Apartment / House #
Road Name/ Number
City
Postal Code
CountryContact Address (Residence)
Apartment/ House #
Road Name/ Number
City
Postal Code
Country
Cell Phone(s)
Home Phone
Work Phone
Fax
Web
PERSONAL INFORMATION
Date of Birth
(dd-mm-yyyy)Blood Group
Spouse Name (if applicable)Marriage Anniversary
(dd-mm-yyyy)
Hobby
No. of Children (if any)
ACADEMIC ACHIEVEMENT (Please list in order to the last degree achieved)
Degree/ CertificarteDiv./ ClassYearInstitute/ UniversityMajor/ Specialization
PROFESSIONAL ACHIEVEMENT (Please list in order to the last awarded)
Degree/ CertificarteDiv./ ClassYearInstitute/ UniversityMajor/ Specialization
LOGIN INFORMATION
Username
Password
This is for account creacin only. You may change your password anytime you want alter you login
Give me a BSHRM e-mail addressIf you check this box, you will be given a BSHRM email address which is .All mails will be forwarded to your existing email account.
CAREER HISTORY Please list below your portfolios & name of organizations you have worked till to date. You may attach additional sheet if you need more space.
Name of the OrganizationPosition heldFromToBrief Description of
Portfolios/ Key Responsibilities
DECLARATION: (By the Applicant):
Signature of the Applicant:
Date:Please attach one copy recent passport size photo
(For Office Use only):
Registration Serial No:
Membership No:
Please submit this form to:
Office Secretary, Bangladesh Society for Human Resource Management (BSHRM),
IIUC Dhaka Campus, House # 23, Road # 3, Dhanmondi R/A, Dhaka-1207, Bangladesh.
Email to HYPERLINK "mailto:[email protected]" [email protected]
Apply for Membership Online @ HYPERLINK "http://www.bshrm.net" www.bshrm.net
I declare that all information provided above, are true and correct and that, I shall comply with all the rules and by-laws, of the society, currently in force. Any change in my current status as an applicant, will be notified to you, within one week from the date of change of status. I agree to pay the current applicable
dues towards becoming a member of the Bangladesh Society for Human Resource Management.
Recommended by:
Accepted by:
Accepted subject to:
Pending for:
Date of acceptance:
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