Be an HR Leader - Join ASHHRA's Leadership Initiative

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	ADD your VOICE to ASHHRA's HR Leadership Initiative. Start by filling out your personal profile.
	JOIN the ASHHRA community in electronic discussion groups on leadership.
	SIGN UP for Leaders VOICE updates. On a regular basis, new developments on ASHHRA's HR Leadership Initiative will be delivered to your inbox.
	RECEIVE exclusive promotions from ASHHRA for HR leadership training and tools - when they become available. By participating in this promotion program, you will become eligible for special offers, discounts and detailed product information.
Please make your personal profile as complete as possible. Items in red are required. If you have questions about the use of this information, refer to our privacy statement.

Username:
Password:
First Name:
Last Name:
Email:
Phone:
Fax:
Organization:
FTE's:	Select One < 100 100 - 250 250 - 500 500 - 750 750 - 1000 > 1000 Not Applicable
My Title:
Current Position:	Select One Chief HR Officer/VP of HR Director Manager of HR HR Professional External Consultant Other
Address/Street:
City:
State/Province:	--please select-- Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Colorado Connecticut Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Lousiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington Washington DC West Virgina Wisconsin Wyoming Yukon Territory
Zip Code:
Country:	-- please select -- Afghanistan Albania Algeria Andorra Angola Anguilla Antigua Argentina Armenia Aruba Ascension Island Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Barbuda Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Islands Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos-Keeling Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Diego Garcia Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Falkland Islands Fiji Islands Finland France French Antilles French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Ginea-Bissau Greece Greenland Grenada Guadeloupe Guam Guantanamo Bay Guatemala Guinea Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Republic Korea North Korea South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Island Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles Nevis New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Principe Puerto Rico Qatar Reunion Island Romania Rota Island Russia Rwanda Saint Lucia Saipan Islands San Marino Sao Tome Saudi Arabia Senegal Republic Serbia (Republic of) Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Kitts St. Pierre and Miguelon St. Vincent Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Tinian Island Togo Tokelau Tonga Trinidad and Tabago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu UAE (United Arab Emirates) Uganda UK United Kingdom Ukraine United States Uruguay Uzbekistan Vanuatu Vatican city Venezuela Vietnam Virgin Islands Wake Island Wallis & Futuna Islands Western Somoa Yemen Yugoslavia Zaire Zambia Zimbabwe
Gender:	Select One Decline to answer Male Female
Years in Healthcare Field:	Select One Under 5 Years 5-10 Years 10-15 Years Over 15 Years Not Applicable
Years in Healthcare HR:	Select One Under 5 Years 5-10 Years 10-15 Years Over 15 Years Not Applicable
ASHHRA Member:	Yes    No
Years of Membership:	Select One New 1-2 Years 2-5 Years 5-10 Years Over 10 Not a Member
Sector:	Select One Hospital (multi or independent) Healthcare System Corporate Office Physician Practice Managed Care Health Plan Consultant or Supplier Other
Check the top 5 critical leadership challenges in your current position:	Leading Change Organizational Management Talent Management Integration of Mission & Vision Relationship-Building Personal Credibility Quality of Service Cultivating Ethical Values Inspiring Others Performance Improvement Systems Thinking Self-Awareness & Learning
About Me:
My preferred method for receiving communication on ASHHRA's HR Leadership Initiative is: Email    Fax    US Mail