Apply to Be a Member | Global Polygraph Network®

Please complete and submit this membership application to join the Global Polygraph Network and to receive client referrals. After you apply, please be prepared to provide us with additional documentation, such as your school certificate, a current CV, and a set of recent charts.

Step 1 of 7

Email
This field is for validation purposes and should be left unchanged.
EXAMINER APPLICATION
Examiner Name(Required)
Mailing address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email address(Required)
Website
Phone number(Required)
Phone number we can supply to clients (if different)
List all states and/or countries where you hold valid (current) polygraph licenses
Polygraph-related professional memberships (APA, AAPP, etc.)
List any high-profile cases, television shows, media events, specialized training, or any other information you would like to appear with your listing on an additional sheet

EXAM LOCATIONS REQUESTED
Provide below a complete list of all locations (city or county & state or country) where you are willing to provide exams. These may be at your own office or at any other physical location that you provide. You may list as many exam locations as you wish, but locations should be at least 30-50 miles from one another. You may either list (1) new exam locations not presently covered (see website), or (2) locations already covered by another GPN examiner if your price is lower than the currently listed price for that location (see web site). Each testing location may have a different fee, keeping in mind that you still want to remain competitive for any given area.

Remember that the proposed fee must include our referral fee (which we collect from the client) and all expenses, so you will actually receive less than the fees quoted below. Sales tax and surcharges for evening and weekend exams may be charged in addition to the listed fees, if required. GPN referral fees, in the US and Canada, are currently 100 USD for exams priced below 1000 USD and 200 USD for exams priced at 1000 USD and above. Outside the US the referral fee is a flat 20% of the published fee.

If necessary, we will help you locate facilities to use for your exams in a given area. If you have not yet identified a suitable testing location in the desired city, just leave the address field blank.
Testing Location #1
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Facility (ie. Private Office, Hotel, Per Diem Office, etc.)
Total fee for one exam at this location
Be sure to include the type of currency (USD, EUR, etc.)
Testing Days and Hours available Here
Add more locations?
- No
- 1 more
- 2 more
- 3 more
Testing Location #2
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Facility (ie. Private Office, Hotel, Per Diem Office, etc.)
Total fee for one exam at this location
Type of currency (USD, EUR, etc.)
Testing Days and Hours available Here
Testing Location #3
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Facility (ie. Private Office, Hotel, Per Diem Office, etc.)
Total fee for one exam at this location
Type of currency (USD, EUR, etc.)
Testing Days and Hours available Here
Testing Location #4
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Facility (ie. Private Office, Hotel, Per Diem Office, etc.)
Total fee for one exam at this location
Type of currency (USD, EUR, etc.)
Testing Days and Hours available Here
Note: If more than four testing locations is requested, please submit that list in a separate email.

SUPPLEMENTAL INFORMATION (to be signed following application approved)
MEMBER REQUIREMENTS
1. Must have completed an accredited polygraph training program.
2. Must be certified (if certification is available from that school).
3. Must use only Validated Testing & Scoring Techniques for GPN clients.
4. Must possess a valid polygraph license for locations requiring licenses.
5. Must have conducted at least 100 specific-issue examinations.
6. Must have conducted at least 50 Domestic Issue examinations or completed GPN’s Domestic Issue training course and subsequent QC evaluation.
7. Must submit (by email attachment) (a) a current Curriculum Vitae, (b) charts and question list from a recent exam (past 30 days), and (c) School Certificate.
8. Must use a polygraph instrument with at least 4 recording channels.
9. Must use motion sensor pads for each examination conducted.
10. Must maintain an email address which is checked daily for assignments.
11. May not be affiliated with John Grogan, Brad Kelly, PEOA, or The Polygraph Group.
MEMBER AGREEMENT
1. Member understands that Clients pay GPN a non-refundable deposit per exam ($100 to $150 per test in the U.S. and Canada). Outside the U.S. and Canada GPN collects 20% of the fee as a deposit. This deposit becomes GPN’s referral fee.
2. Member agrees to accept GPN referrals by email.
3. Member agrees to attempt to contact the client within 2 business days by all means available (email, phone, text) and maintain records of all client contacts and attempted contacts in the event of disputes.
4. Member agrees not to refuse GPN assignments without a justifiable reason.
5. Member agrees to offer the client exam dates within 30 days of the assignment date.
6. Member agrees to conduct all assigned exams personally. Member may not subcontract assignments to any examiner not approved in writing by GPN.
7. Member agrees to charge clients the predetermined (published) fee less the GPN deposit.
8. Member must furnish typewritten reports to the client at no additional charge.
9. Member must use the GPN online portal to update the status of each assignment.
10. Member must retain client’s signed GPN credit card authorization for 6 months.
11. Member will provide assistance in resolving payment and credit card disputes.
12. If Member has a website, this site must include a back link to www.polytest.org or each referral fee will be increased by $50 per exam.
13. Member must complete at least 16 hours of polygraph CE credits every two years.
14. If a client contacts the Member for additional testing at a later time, Member must pay GPN any referral fees due for the additional exams as if the client had registered with GPN again.
15. Member must agree to provide the exam room at no additional fee.
Prove you are human!

GPN Membership Application

Step 1 of 7

EXAMINER APPLICATION

TRAINING

EXPERIENCE

Techniques and Equipment Used

PREFERENCES

EXAM LOCATIONS REQUESTED

SUPPLEMENTAL INFORMATION (to be signed following application approved)

MEMBER REQUIREMENTS

MEMBER AGREEMENT

GLOBAL POLYGRAPH NETWORK®

IMPORTANT LINKS

SERVICES

GET IN TOUCH!

717.348.0621

QUICK CONTACTS