Intake Form for Interpretation Services
Email
*
example@example.com
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
0rganization
*
Has the CLA Translation Institute completed a project for you in the past?
Yes
No
Organization url if applicable
Mission of Organization
*
Key Services/Programs Offered
*
Approximately how many individuals does your organization serve annually?
*
% of clients who are LEP (est.)
*
What language pairs do you need for the interpretation?
*
Chinese/English
Spanish/English
What is the subject matter of the interpretation? Please note that the CLA Institute will not provide court interpretations nor medical interpretations between a patient and healthcare worker.
*
Audience and Goal of Interpretation
*
Types of Interpretation
Consecutive: One party speaks a few sentences and then pauses for the interpretation. The interpreter takes notes. Simultaneous: The interpreter processes the speech silently and delivers the message as the speaker talks. Please note that our staff only practice CONSECUTIVE INTERPRETATION.
Do you agree to consecutive interpreting if we are able to provide services to your organization? See above for a description of consecutive interpretation.
*
Yes
No
Number of Individuals needing Interpretation (if more than a 2 person meeting).
*
What modality do you require for the interpretation?
*
In-person
Videoconferencing (ZOOM, Google Meet, Microsoft Teams, etc.)
Telephone
If in person, please indicate the location.
*
Estimation of minutes/hours that will be spent interpreting.
*
Date of interpretation
*
-
Month
-
Day
Year
Date
Time of interpretation. Please note a 30 minute initial pre-meeting is required for interpreter to meet with all parties
*
Hour Minutes
AM
PM
AM/PM Option
Additional questions or comments
What kind of resources do you currently use for your interpretation needs?
*
How did you hear about us? Please check all that apply.
*
Word of mouth
Internet search
Outreach email from the CTI
Postcard from the CTI
Bulletin Board Posting
Other
If other, please indicate below.
*
Your signature indicates that you agree to interpretation services by supervised undergraduate students.
*
Submit
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