Membership Application

Applicant must be present at an IPA Conference in order to be voted into membership. If the applicant is not available then the vote for membership will be tabled until the applicant is present.

Note to applicant: All answers must be in full, including any additional information for consideration.

Polygraph Training
Polygraph Experience
Background
References
Payment

I agree to pay the sum of $75.00 for membership payment of annual dues, payable at time of submission of application. (In the event application is not accepted, full return will be made.) I further agree to hold said Indiana Polygraph Association, its members, examiners, officers, and agents free from damage, liabilities or complaint, by reason of any action they, or any of them, take in connection with this application.

Mail Payment to:
Make checks payable to Indiana Polygraph Association

Indiana Polygraph Association
Justin Naish
6610 Constitution Drive
Fort Wayne, IN 46804
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