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Name:________________________________________________________________________

Job Title:______________________________________________________________________

Business Name:_________________________________________________________________

Address_______________________________________________________________________
        Street or P.O. Box, City, State, and 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 a member of our EUROPEAN BRANCH.

____Please check here if you wish to be included in the Axiological Service Provider Directory. If so:
(1) Please tell us which version or parallel form of the HVP you will be using:
_______________________________________________;
(2) send a check (or PayPal) 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 is: Regular members: $75.00; Student and Retiree members: $25.00. This price covers a subscription to the JOURNAL OF FORMAL AXIOLOGY: THEORY AND PRACTICE postage paid anywhere in the world.

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
Fax: 903-677-6692
E-mail: Darlene@valuepartnersconsulting.com

If you live outside the United States and or otherwise wish to pay by PayPal, go to our "Membership Directory" for instructions on paying an extra 2%.