The Human Resources (HR)
Information Center

Registration Form

Name: _________________________________________

Company: ______________________________________

Title: _________________________________________

Phone: _________________________________________

E-mail: _________________________________________

Address: _______________________________________

State: __________________________________________

City: ___________________________________________

ZipCode: _______________________________________



Indicate by your signature that you have read and understand our membership
agreement and disclaimers.



________________________________ ____________________
Signature Date


Please mail with your check or money order to:

JMT & Associates, LLC
Corporate Office
829 N. Geyers Chapel Road
Wooster, Ohio 44691

Attn: Membership Department

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Associates, LLC

Human Resources & Safety Consulting

JMT &