Bangladesh Society for Human Resources Management (BSHRM)

Registration No: S-2657(70)/2001

MEMBERSHIP APPLICATION FORM

Picture
(For Office Use only):
Registration Serial No:

Membership No:

PLEASE WRITE ALL INFORMATION REQUESTED BELOW AND MARK N/A WHICH ARE NOT APPLICABLE FOR YOU.

MEMBERSHIP INFORMATION
Category
(office
StudentGeneral 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
use only) 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: (Telecom, Banking, Real Estate, Total years of working experience:
Garments, Corporate, NGO, INGO etc.)
Total years in HR:
CONTACT INFORMATION
Contact Address (Office) Contact Address (Residence)

Apartment / House # Apartment/ House #

Road Name/ Number : Road Name/ Number
City : City
Postal Code Postal Code
Country Country
Cell Phone(s): Home Phone (Cell):

Work Phone: Fax:

Email: Web:

PERSONAL INFORMATION
Date of Birth (dd-mm-yyyy) : Blood Group:

Spouse Name (if applicable): Marriage Anniversary (dd-mm-yyyy):

Spoue Blood Group:
Hobby: No. of Children (if any):

Highest Degree:
Degree/Diploma on HRM:
Specilization:
Professional Attachement (except BSHRM) please mention 03 names
only:
ACADEMIC ACHIEVEMENT (Please list in order to the last degree
achieved)
Degree/
Div./ Class Year Institute/ University Major/ Specialization
Certificarte

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 Position Brief Description of
From To
Organization held Portfolios/ Key Responsibilities

LOGIN INFORMATION
Username Password (User name):
This is for account creacin
only. You may change your
password anytime you want (Password):
alter you login

DECLARATION: (By the Applicant):

Recommended by:
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
Accepted by:
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 Accepted subject to:
Resources Management.

Pending for:
Signature of the Applicant:
Date of acceptance:
Date:

Please submit this form to:

Office Secretary, Bangladesh Society for Human Resources Management (BSHRM),
rd
House # 412 (3 Floor ), Road # 29, New DOHS, Mohakhali, Dhaka-1206, Bangladesh.
Email to namin_bshrm@yahoo.com
http://www.bshrmbd.org