Online Contract Interpreter Application *If you do not receive an email confirmation within 24 hours please call 727-271-0160. First Name: Last Name: Interpreting Credentials: Years Received: Degree(s) Held: Years Received: Field(s): School: Address: City: State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zipcode Cell Phone # (include area code): Alternate #: Email: Fax: How did you find out about our services? Interpreter ReferralDeaf ConsumerEmailRID WebsiteFRID WebsiteOther Name of Referral (if applicable): Please indicate where in Florida you are willing to work & notify of any changes (check all that apply): West Central Florida (our main service area) Marion/Sumter/Lake Citrus Hernando West Pasco East Pasco North Pinellas South Pinellas North Hillsborough South Hillsborough Polk Manatee/Sarasota Additional Areas: (www.floridacountiesmap.com) Northwest FL North Central FL Northeast FL Central FL East Central FL Southwest FL Southeast FL Scheduling: You will be contacted for assignments based on your skill, location, experience, personal preferences, and consumer/business client needs/preferences. Indicate your willingness to work & notify of any changes (check all that apply): Weekdays Weekends Full Day (Community) Full Day (Education Setting) Willingness to work after hours: After Hours (7pm-7am) Other; 7pm until: (please specify) Most availability inquires are sent via text message. Please note if you wish to be contacted in the middle of the night another way: Indicate any specific day/time you cannot work: Check off settings where you have previous work experience: Performing Arts Theatre Performing Arts Music Cruises Legal Deaf/Blind Tactile Deaf/Blind Close Vision Deaf/Blind SSP Medical Religious Weddings Funerals Business Conference Educational Mental Health Inpatient Mental Health Outpatients i.e. one-on-one Counseling, Groups, etc. Indicate any specific setting(s) you do not wish to work in: Indicate any specific training(s) held: Are you fluent in any other languages? (please list) Do you have personal specialized experience in any other fields/situations that might be useful in certain assignments? i.e. computers, cosmetology, boating, artist, realtor, accountant, nursing, etc. (be specific) Are you interested in working Legal Settings? Yes No Years of Legal Interpreting: Note Specialist Legal Certificate held (if any): List Legal Setting Experience: Do you already own an "Interpreter Badge"? (if no, please inquire about purchasing one for yourself) Yes No Have you already completed any of the following screenings? Level 1 Background Screening Yes No Where: Level 2 (fingerprint) Screening Yes No Where: TB Test Yes No Where: *Please note that some business customers require that certain screenings or additional documentation be completed in order to utilize your services. We will notify you of such interpreting opportunities/requirements i.e. School Systems, Vocational Rehabilitation, Medical and Mental Health Facilities, etc. We appreciate your time in becoming an authorized interpreter for these business customers for additional interpreting opportunities. Download blank W-9 Form Form Uploads Do you have a copy of your Liability Insurance? Yes No Upload Liability Insurance Form Do you have a copy of your Drivers License? Yes No Upload Drivers License Copy Do you have a Resume? Yes No Upload Resume Do you have a copy of your credentials? Yes No Upload Credentials Do you have a completed W-9 form? Yes No Upload W-9 Form Please attach the above documents to this application. If you are unable to attach your documents at this time, please send them to us by fax (888) 228-7575 or by email JHarris@JHinterpretingservices.com. If you are human, leave this field blank. Submit