New Member Application

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Institutional Information

Institution Name: *

Institution City: *

Institution State: *

Institution Home Page:

HR Office Home Page:

Institution Type: *

System Office/Board of Regents institutions are automatically assigned Dues Code 4. Please make sure that Dues Code 4 is selected on the following page.

Due to our current promotion for Community Colleges, you will receive a 10% discount on your dues.

You selected "Other." Please specify:

Support:

Your Contact Information

Your Name: *

Your Phone: *

Your E-mail: *

If membership in CUPA-HR was recommended by another member, please note his/her name and institution:

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Dues Schedule for Institutional Membership

CUPA-HR has institutional-based memberships. The number of members allowed in an institution's membership is determined by the institution's total budget (not the HR department's budget).

If you know your IPEDs Unit ID, click here to lookup your Dues Code.

If you know your institution's total budget, but do not know your IPEDs Unit ID, click here to look up your Dues Code. Your budget information will be verified by CUPA-HR before your membership is activated.

If you do not know your Unit ID or your institution's total budget, please contact CUPA-HR Member Service toll-free at 877-CUPA-HR4 (877-287-2474) or via memberservice@cupahr.org.

System Office/Board of Regents institutions are automatically assigned Dues Code 4 and the corresponding 8 representatives. You are welcome to add additional representatives on the following page for $30 each.

Please select 4 in the Dues Code drop-down box below.

Dues Code: *

Dues:$

Your dues amount listed here reflects a 10% discount given during our Community College promotion.

You will be able to add additional representaties on the following page. Additional representatives are $30 each.

Representatives

Key Representative

List the person most responsible for directing the human resource function. This person will be the key contact for CUPA-HR.

Name *

Title: *

Street Address *

Address continued

City *

State *

Zip *

Telephone: *

Fax:

E-mail: *

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