Name:______________________________________ Birth Date:_______________________
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.
If you are or wish to become a Consultant in Good Standing, please (1) tell us which version of the HVP you will be using:_______________________________________________;
(2) please tell us if you will be paying your own royalties on the HVP, or else give us the name and e-mail address of your Distributor for the Hartman Value Profile ____________________________________________________________________________________; and
(3) please describe the training you have had in using and interpreting the HVP
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Beginning in 2008, the normal dues schedule for the calendar year is: Regular members: $80.00, which covers a subscription to the JOURNAL OF FORMAL AXIOLOGY: THEORY AND PRACTICE. Student and Retiree members: $10.00 plus $30.00 for the JOURNAL..., for a total of $40.00.
New regular members joining between January 1 and May 31 will pay the full annual membership fee of $80.00. 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 $30.00 for the JOURNAL..., for a total of $55.00; persons joining between September 1 and December 31 will pay $12.50 for the rest of that calendar year plus $30.00 for the JOURNAL..., for a total of $42.50. Thereafter, everyone pays full membership dues, $80.00 per year. Late subscribers will receive back issues of the JOURNAL... for the year in which they become members. 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/FAX: (713)-772-6429
E-mail: Darlene@darleneclark.com
If you live outside the United States and wish to pay by PayPal, go to our "Newsletter" page for instructions.