Membership Registration Paypal – IAVSA Registration

Please complete the following application and press the "Submit" button at the bottom of the form. Your application for membership will be promptly processed.

Are you a new or Returning Member? *Returning MemberNew Membership

Please List Names of Applicants to Renew Membership *

Department or Organization *

Street Address *

Division, suite, etc

City *

State *

ZIP / Postal Code *

Email Address *

Phone Number *

Voice Stress Instrument Used *

* Disclaimer

I {name-1} {name-2} certify that all information contained in this application is complete and true to the best of my knowledge. I understand that any material omission, misrepresentation or falsification of this information is grounds for dismissal or refusal of membership to the IAVSA Association. I hereby authorize investigation of all statements contained herein and give permission to contact any or all of my previous employers, references and/or schools attended for information.

First Name *

Last Name *

Department or Organization *

Street Address *

Division, suite, etc

City *

State *

ZIP / Postal Code *

Email Address *

Phone Number *

IAVSA / CVSA / VIPRE Systems / FVSA Basic certified?

Select if you are IAVSA / CVSA / VIPRE Systems / FVSA Basic Certified

IAVSA / CVSA / VIPRE Systems / FVSA Basic Certification

Your Instructor *

Graduation Date

VSA Certification (Most Recent)

Location of Training *

VSA Graduation Date

Polygraph Qualified? *YesNo

Upload Certification Certificate (If Applicable)

No file chosen

* Disclaimer

Membership Dues

IAVSA Membership dues are valid for two years for a total cost of $80 per membership.

Membership Dues

IAVSA Membership dues are valid for two years for a total cost of $80 per membership.

I Understand and agree to all terms Listed above

Membership Dues