Psychological Screening Registration Form (2022)

PSPG Psychological Screening (2022)

REGISTRATION FORM Please fill out the top section of the form fully to register for any of our scheduled testing dates. NOTE that payment can be made today or at a later date via check, purchase order, etc. Please mark which type of PSYCH SCREENING is appropriate in the lower section of this form before hitting the SUBMIT Button. Note that testing starts at 8:15am on the scheduled day and lasts 4-5 hours. A follow-up interview will be scheduled at the time of testing.
Name of Individual to be Tested

First Name Middle Name Last Name
Testing Date Requested
Department or Agency Requesting Testing
Name of Department Contact or Individual Scheduling Testing

First Name Last Name
Department Contact Email
example@example.com
Department Contact Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Additional Comments

PAYMENT OPTIONS- Please Choose One of the Options Listed Below

Submit Registration with Future Payment Via Check or Purchase Order

$ Free

Standard LAW ENFORCEMENT Screening$350 plus GRT

$377.56

Level 3 SECURITY Screening$275 plus GRT

$296.66

SPECIALTY ASSIGNMENT Law Enforcement Screening$350 plus GRT

$377.56

Psych SCREENING INCLUDED in Current Agency Contract

$ Free

Total

$0.00

PSPG Psychological Screening (2022)