SHRM Registration Form

Spring 2009

You will receive a confirmation letter one week prior to the start of class.

Please provide the following contact information:
First Name
Last Name
Company
Address Line 1
Address Line 2
City
State
Zip
Phone
Fax
E-mail address
Home Address
City
State
Zip
Home Phone
Are you an alumnus of Ball State University?	Yes No

Please choose payment method
Payment Method

Please indicate which option meets your needs
Course Options
University Credit	Yes No

You also may print this form and then fax it in with your credit card information to (765) 285-1284.