APPLICATION TO BECOME A COURT INTERPRETER
Approved Certified Please type or print legibly. Answer all questions fully. Please enter "None" for any blank responses. Language(s) you are fluent in: Your Full Legal Name: (Last Name, First Name, Middle Name) Date of Birth:
Social Security Number: Mailing Address:
(Street, City, State, Zip Code) E-mail Address: Daytime telephone number(s) with Work: Cell: area code: Home: Your gender: Male Female 1. Translating & Interpreting Formal Training Have you received formal Translating & Interpreting training at a college or university? Do not include related courses such as linguistics, law, or language. If so, did you receive a certificate or diploma? Please describe:
2. Level of Formal Education in Language other than English What is the highest level of formal study you have completed in a language other than English?
3. Level of Formal Education in the English Language What is the highest level of formal study you have completed in the English language?
4. Comparison of Your Mastery of Languages Please compare your mastery of your primary non-English language with your mastery of the English language. Consider pronunciation, ability to read, write, comprehend, and speak, range of vocabulary, and grammatical skill. Select the answer that most closely describes your comparative ability in the two languages. Check only one box. My use of English is much better than my use of the other language.
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My use of English is somewhat better than my use of the other language. I have approximately equal mastery of both languages. My use of the other language is somewhat better than my use of English. My use of the other language is much better than my use of English.
5. Years Lived in Different Linguistic Contexts How many years have you lived in countries where your primary non-English language was the dominant language?
How many years have you lived in countries where English was the dominant language?
How many years have you lived in countries where the primary language was neither English nor your primary non-English language?
6. National Origin Write the name of the country that best describes your national origin.
7. Interpreter Certifications Have you ever taken an interpreter certification test (Consortium, NAJIT, FCICE, other state)?
Have you ever held or do you currently hold an interpreter credential? Describe.
8. Interpreting Experience Have you ever worked as an interpreter? If yes, in which state(s)?
As an interpreter, have you ever received disciplinary action? If so, what was the outcome?
9. Criminal Background Investigation Do you agree to undergo a criminal background investigation?
The information I have provided on this application is true and correct to the best of my knowledge. I hereby authorize the courts to conduct a thorough background check including but not limited to references, employment record, and criminal record. I understand that all information will be kept confidential and released only to authorized individuals. I also understand that any falsification of data on my part will result in disqualification to interpret in the Utah Courts. I hereby release the courts from any civil or criminal liability arising from my background check. Signature: _________________________________________________ Date: __________________
Mail completed form to: Rosa P. Oakes Administrative Office of the Courts P.O. Box 140241 Salt Lake City, UT 84114-0241 e-mail: email@example.com Fax: 801-578-3843
Page 2 of 2 Rev. 11/2008