Membership Application Form - Employers Resource Association

Membership

Company Name*
Mailing Address*

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Address Line 2

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City*
State*
ZIP Code*
County*
Contact Name*
First Last
Phone*
Email*
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Federal ID No.*
Discount Code
Total Average FTEs membership will cover*
(for demographic purposes only)
Average Total Employed Company-wide*
(for demographic purposes only)
HR Department Size*
Other states you have employees
Industry
Business Structure*
check all that apply
Nature of Business
Does your company provide any form of human resource services/products?
Reasons for Joining*
How did you hear about us?*
Referral Source

Enter person or company name
Referred By
Consent*
I agree to the privacy policy.
Confidential Information
You will receive information and various publications as a privilege of your membership with Employers Resource Association. You hereby acknowledge that the information provided in these publications is confidential and trade secret information that is solely and exclusively owned by ERA. You agree to hold such information in the strictest confidence and will not disclose this information to any third party person, firm or corporation, either orally or in writing. CONFIDENTIAL AND TRADE SECRET INFORMATION MAY NOT BE USED FOR CONSULTING SERVICES unless your client receives this information from ERA through your client’s own membership. In no way should this information be used in such a way that may destroy the confidentiality or secrecy of this information.

You are permitted to provide specific ERA information to certain third parties that you may hire for services relating to the operation of your business. These third parties may use ERA’s confidential and trade secret information in performing services for your internal organization only.

You are required to notify the third party that ERA confidential and trade secret information shall be used only for services provided by the third party to you, and the third party shall not disclose such information to any other person. You understand that you are not permitted to copy or transmit this information in any way. You acknowledge responsibility for obtaining from the third party any ERA publications you provided the third party in performance of their services.

Please note: Violations of this agreement may result in the revocation of membership privileges and legal action.

Dispute Resolution
You agree that any dispute arising out of, or relating to, your membership, our relationship, or services rendered shall be resolved by confidential, binding arbitration between the parties. This includes, but is not limited to, any claims regarding or related to the information or services provided to you by Employers Resource Association, fees, charges or costs for services rendered by Employers Resource Association, and whether such services or information were improperly, negligently, or incompetently rendered, or otherwise rendered in breach of a contractual or ethical duty.

You understand and acknowledge that, by agreeing to binding arbitration, it waives and thereby eliminates the right to submit the dispute for determination by a court and thereby also waives the right to a jury trial. You acknowledge that you have been informed that the grounds for appeal of an arbitration award are very limited compared to a court judgment or jury verdict. Consequently, you should carefully consider whether arbitration is acceptable and should consult with independent counsel.

Arbitration shall be in accordance with the Uniform Arbitration Act of Ohio. The dispute will be resolved by a single arbitrator to be selected by the parties.1

I hereby certify that I have read this Application and will comply with the Confidential Information and Dispute Resolution provisions as stated above. I also certify that I will keep all information under the appropriate security safeguards in order to prevent any unauthorized disclosure to others.

Membership is subject to approval of the Board of Directors.
Name*
First Last Title
[1] If in the opinion of any party, there arises a problem or unreasonable delay with the administration of the dispute, including but not limited to scheduling any hearing, any party upon 10 days written notice to the other, shall have the right and power to notify and engage the American Arbitration Association (AAA) to commence formal administration of the proceeding before the AAA in accordance with its then prevailing rules. The award rendered by the arbitrator(s) shall be final and may be confirmed in any court having jurisdiction thereof.
Name
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