FORM-I-2-POLYGRAPH-QUESTIONNAIRE - Pre-Employment Polygraph Questionnaire Form I-2

Sep 30, 2026

Pre-employment polygraph questionnaire for applicants seeking law enforcement-related professional standards roles in Kentucky, administered through the Kentucky Law Enforcement Council (KLEC). Includes general instructions, requirements for honesty, guidance on answering or marking unanswered items, and directions for completing the form with ink and comments. Collects personal identity, citizenship, name/Social Security/date variations, marital status, prior polygraph experience, education history, and detailed military and employment history fields.

LanguageEnglish

CategoryExam

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

GENERAL INSTRUCTIONS

INSTRUCTIONS TO JOB APPLICANT

PERSONAL INFORMATION

EDUCATION

EMPLOYMENT HISTORY - MILITARY

EMPLOYMENT HISTORY

KENTUCKY LAW ENFORCEMENT COUNCIL Peace Officer Professional Standards Telecommunicator Professional Standards Court Security Professional Standards PRE-EMPLOYMENT Polygraph Questionnaire FORM I-2 APPLICANT NAME: Agency applying with: Position applying for: Date of Examination: Assigned Time: Testing Site: GENERAL INSTRUCTIONS: This questionnaire should be completed PRIOR to arriving at the test site. Please give this form to the examiner on the day of testing. If it is incomplete, the exam may be rescheduled. Drug testing is customarily administered on the same day as polygraph examinations. If your agency has scheduled you for a drug screen, please arrive to the test site prepared to give a urinalysis sample. Agencies must notify the KLEC office of cancellations a minimum of 24 hours in advance to avoid being charged a No Show fee. Notify your agency if you do not intend to keep your appointment. Call the KLEC office at 859-622-6218 on the day of your appointment if you are running late or are lost. Revised June 2014 INSTRUCTIONS TO JOB APPLICANT Before completing the following questionnaire, it is important for you to understand the purpose of the polygraph examination you will be taking. Law enforcement officials are expected to have a high degree of honesty and integrity. If law enforcement agencies only hired people who had never made a mistake, done anything wrong, nor ever committed a crime, there would be no one in law enforcement positions. There are no perfect people. The purpose of this questionnaire and the forthcoming polygraph examination is not to find the perfect person. This questionnaire and the polygraph examination have been designed to assist in identifying the honest person. Agencies seek people they can trust. No law enforcement agency should hire someone that cannot be trusted. Your word is your bond. The law enforcement community, the court systems, and society as a whole must be able to trust their law enforcement officials. As you fill out this questionnaire, above all – be honest. • While completing the questionnaire, answer all questions to the best of your ability. It is understood that no one can remember every detail or every exact date, but again, aim to answer to the best of your ability. • If you do not understand a question, do not answer it. Put an asterisk (*) by the question number. The polygraph examiner will explain the question. • The polygraph examiner will explain the process in detail. If you have questions, you will be given an opportunity to address those with your examiner. It is important that you discuss any concerns or questions prior to the polygraph examination. • Do not lie in this questionnaire. Do not lie in the polygraph examination procedure. • Lying is an intentional act. Do not intentionally leave out information. Do not intentionally misrepresent information. Write in black or blue ink. Make comments as needed and write on the backside of these pages when necessary. PERSONAL INFORMATION: Full Legal Name: (First) (Middle) (Last) Date ofBirth: Age: Soc. Security \#: - _ - Place of Birth: (City/State/County) Current Address: (Street) (City) (State) (Zip) How long living at current address?: Home phone number: () - List all other states and/or countries in which you have lived: Have you ever used a different name? Have you ever used a different social security number? Have you ever used a different date ofbirth? Are you a U.S. citizen? If yes, please check one: U. S. born U. S. naturalized Other: Yes Yes Yes Yes No No No No Marital Status: Single Married Divorced Separated Other: Have you ever taken a polygraph or other type of honesty test? Yes No If “yes”: 1.) (Year) (Agency that administered test) (Purpose or Reason) 2.) (Year) (Agency that administered test) (Purpose or Reason) EDUCATION: G.E.D.? Yes N

FAQs

When should the polygraph questionnaire be completed and submitted?

Complete the questionnaire prior to arriving at the test site and give it to the examiner on the day of testing. If it is incomplete, the exam may be rescheduled.

What does the form require regarding honesty and how to handle questions you don’t understand?

Answer all questions to the best of your ability and do not lie or intentionally leave out or misrepresent information. If you do not understand a question, do not answer it and place an asterisk (*) by the question number.

What personal and background information does the questionnaire collect?

It requests full legal name, birth details, current address, time at the address, citizenship status, whether you used different names or Social Security numbers or different dates of birth, marital status, prior polygraph or honesty tests, and detailed education and employment history including military service and prior employers.

Sep 30, 2026

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