PMC_Contract_Court_Interpreter_Application.pdf

ATTACHMENT E – Contract Court Interpreter Application - PMC RFQu-25-001 1/3

ATTACHMENT – E

PHOENIX MUNICIPAL COURT

CONTRACT COURT INTERPRETER APPLICATION

NOTE: A typewritten application must be filed with the City of Phoenix Municipal Court Interpreter Office, 300 West Washington, 9th Floor, Phoenix, AZ 85003.

Social Security Number Tax ID Number

LANGUAGE PROFICIENCY

Language Dialect Certification Tier

Number Dates Credentialed

Yes No

EDUCATION

Schools Attended Location Major Degree Hours Date Completed

Interpreter Name/Agency Name

Address City State Zip Code

Cell (or Home) Phone Work Phone E-mail address

ATTACHMENT E – Contract Court Interpreter Application - PMC RFQu-25-001 2/3

Please list court or related interpreting experience:

(Please indicate dates and length of experience. Include any agencies you have worked in the past.)

Please list professional certifications, associations, education, or related training to this field:

(Indicate the dates of certification, education and training)

ATTACHMENT E – Contract Court Interpreter Application - PMC RFQu-25-001 3/3

Schedule Availability (Please check the days and times you are available to work.)

Days Morning Afternoon

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday Additional Comments/Information:

Certification

I hereby certify that all the information contained on this application is true to the best of my knowledge and I understand that omissions or mistakes may be cause for rejection, removal of my name from consideration of internship or discharge from contract employment. It is my responsibility to keep the Phoenix Municipal Court advised of any changes to my address or telephone number(s). I understand that a background check may be conducted as a term and condition on internship or contract employment.

Signed: Dated:

ATTACHMENT – E