Name:______________________________________
Job Title: ________________________________
Business Name:_____________________________
Address:_____________________________________________________________________________
Street or P.O. Box City State Zip Code
Telephone:_________________________________E-mail:___________________________________
Fax: __________________________________
Website Address: ____________________________________________________________
Highest Degree (give initials):________ Date of Degree:___________________
University or College:________________________________________________________
Applicant's Signature:_______________________________ Date:____________________
List Two References (New Members Only):
1)____________________________________________________________________________ ______________________________________________________________________________
2)____________________________________________________________________________
______________________________________________________________________________
____Please check here if you also wish to be a member (at no extra cost) of our Spanish-speaking IBEROAMERICAN BRANCH.
____Please check here if you wish to be included on the Axiological Service Provider Directory. In addition,
(1) tell us which version of the HVP you will be using:_______________________________________________;
(2) send a check for $250 with a signed copy of of our Code of Ethics along with your membership check and this form; and
(3) please describe the training you have had in using and interpreting the HVP
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
The normal dues schedule for the calendar year is: Regular members: $65.00, which covers a subscription to the JOURNAL OF FORMAL AXIOLOGY: THEORY AND PRACTICE. Student and Retiree members: $10.00, plus $15.00 for the JOURNAL..., for a total of $25.00.
New regular members joining between January 1 and May 31 will pay the full annual membership fee of $65.00. Later in the year, NEW MEMBERS ONLY will pay a graduated scale of dues. Persons joining the Institute between June 1 and August 31 will pay $25.00 for the rest of that calendar year plus $15.00 for the JOURNAL..., for a total of $40.00; persons joining between September 1 and December 31 will pay $12.50 for the rest of that calendar year plus $15.00 for the JOURNAL..., for a total of $27.50. Thereafter, everyone pays full membership dues, $65.00 per year. Late subscribers will receive back issues of the JOURNAL... for the year in which they become members. Subscribers outside the United States must add an additional $10.00 per issue to cover the cost of postage. There are no graduated membership dues for students and retirees.
Please send your application and a check made out to the R. S. Hartman Institute to:
Darlene W. Clark
Treasurer
Robert S. Hartman Institute
3201 Bandera St.
Athens, TX 75752
Phone: 903-677-5860 Fax: 903-677-6692
E-mail: Darlene@darleneclark.com
If you live outside the United States and or otherwise wish to pay by PayPal, go to our "Membership Directory" for instructions.