Name
*
First Name
Last Name
Middle Name - If you do not have a middle name, please type 'none'
*
Doing Business As (if working under a business name):
EIN (if operating as a DBA)
Date of Birth
*
Social Security number:
*
Do you consent to a background check?
*
Yes
No
Requested rate per hour
blanks
.
Requested rate per hour
*
Do you have any rate differentials? If so, please list them below: i.e. after hours rate, etc
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have a separate mailing address?
Yes
No
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Carrier (allows us to text from the scheduling system):
*
Example: Verizon, AT&T, T-Mobile
Preferred method(s) of communication
*
Email
Text
Phone call
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Clothing T-shirt size:
Extra Small
Small
Medium
Large
XL
XXL
3XL
What date can you begin accepting assignments?
*
What is your current availability during the week?
*
Please List Your Current Certification(s) - Please email copies to veronica@aslcomm.com
*
Skill Sets and Qualifications
Please list all the languages you are qualified to interpret in
What subject areas/settings are you qualified to interpret in? Please select all that apply.
Medical
K-12
Legal
Higher Education
Community
Please select in which of the settings below you are willing to interpret in:
In Person
OPI (Over the Phone Interpreting)
VRI (Video Remote Interpretingl)
Please list any other details you would like to provide about what settings you are comfortable interpreting in:
Self Identification
Many clients request specific demographics or skills based on cultural competency, comfort and trust. The following questions are to meet those needs. You are not required to answer these questions, but it may limit options if you meet a characteristic and we do not know.
Heritage Identity
African American/Black
Caucasian/White
Indigenous
Hispanic
Other
Gender Identity
Female
Male
Nonbinary
Gender Nonconforming
Prefer not to say
Other
Other Identities
Religion or Spiritual Affiliation
LGTBQ
Person with disability
Other
How did you hear about us?
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