2nd Annual Women in Leadership Registration

First Name *

Last Name *

Phone number *

E-mail address *

Are you a SHRM Member *

Yes

No

Check yes or no

Are you Certified? *

Yes

No

Check Yes or No

Local Chapter Member *

Please select on option

Please Confirm Payment Method *

Check Payment

Pay Online

Please let us know if you will be mailing in a check payment. Payments can be mailed to Central Wyoming HR Association P.O. Box 2113 Casper, WY 82602

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