TALEPI 2022 Membership Form
Please read the instructions before completing.
Cost of Membership: $25 - Can be paid online or a check can be mailed. Membership runs from June 1, 2022 through May 31, 2023. If you attend the Summer Conference, your dues are part of your registration fee. Membership applications will be voted upon at the Summer Conference, and you will be notified of your membership acceptance following the Business Meeting.
Name
First Name
Last Name
Title
Agency
Agency / Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
What is your current agency status?
Full-Time with a Department
Honorably Retired from a Department
Business Owner / Work at a Private Firm
Out of State
Check which Class of Membership you are applying for:
Active - Employee of government agency within Texas
Associate - Polygraph examiner from State or Federal agency outside of Texas or any Texas examiner who conducts exams for a criminal justice agency
Affiliate - Non-examiner interested in furtherance of the polygraph profession
Honorary - Bestowed by vote of Board of Director (no dues)
List all polygraph licenses you posses by State, License # and dates issued
When and where did you obtain your Basic Polygraph Training? List school name, school director, intern supervisor, and graduation date.
Applicant’s years of polygraph experience:
Number of law enforcement exams conducted:
List other Professional Associations applicant is member of:
Have you ever been denied a polygraph license?
Have you ever been denied entry into a polygraph school?
If “yes” to the previous two questions, please list details.
List three (3) polygraph examiner references - provide name, phone number and email.
Conference Payment:
I will be paying online.
My agency will be mailing in a check.
Please invoice my department.
My Products
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2022 Membership Dues
June 1, 2022 - May 31, 2023 - Acceptance upon vote at Summer Conference
$
25.00
Credit Card
Submit
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