SHRM23 Student Group Registration - Formstack

School Name*

Point of Contact*

First Name

Last Name

Point of Contact E-mail *

Phone Number*

School Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Number of SHRM23 Student Registrations*

Registration Type*

In Person Virtual

Purchasing Student Membership?*

Yes No

Number of Student Memberships

Preferred Method of Payment

Credit Card ACH/Wire Check