POLYGRAPH EXAMINATION CONSENT AGREEMENT
Date of Examination _______________________
My agreement to undergo a polygraph examination on
the above date is completely voluntary.
A company representative has advised me of the following legal right(s)
relevant to this examination:
I am aware that according to law, I am guaranteed
the right not to take this examination as a condition of employment or
I hereby certify that I have not been coerced in any
way into taking this test or signing this consent agreement.
I have kept a copy of this agreement for my records.
Signature ___________________________ Date ___________________