Date________________________

PLEASE CHECK THE FOLLOWING:

_____ I will attend the Annual Conference in Knoxville on Oct. 5-7, 2006.

Name____________________________________________________________________________

Postal Address__________________________________________________________________

________________________________________________________________________________

Name of Business________________________________________________________________

Job Title_______________________________________________________________________

Home Phone______________________________________________________________________

Business Phone__________________________________________________________________

Fax_____________________________________________________________________________

E-mail Address__________________________________________________________________

Website_________________________________________________________________________

I ENCLOSE A CHECK FOR THE FOLLOWING CHECKED ITEMS:

______ Annual Hartman Conference, $50.00

______ Membership Dues for 2006, $50.00

Please send your registration to:

Dr. Rem B. Edwards

Secretary/Treasurer

Robert S. Hartman Institute

8709 Longmeade Drive

Knoxville, TN 37923 USA