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    N Pinellas    S Pinellas    N Hillsborough    S Hillsborough
Polk    Manatee/Sarasota

Additional_Areas: www.floridacountiesmap.com

NW FL    N Central FL    NE FL    Central FL    East Central FL    SW FL    SE 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)

Please Note willingness to work after hours:

After Hours (7pm-7am) After Hours (7pm - *note end time)
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

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If yes, please complete the following:
Years of Legal Interpreting:

Note Specialist Legal Certificate held (if any):

List Legal Setting Experience:

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Do you already own an "Interpreter Badge"?Yes  No
(if no, please inquire about purchasing one for yourself)

Have you already completed any of the following screenings?

Level 1 Background Screening   Yes  No
If yes, when/where:

Level 2 (fingerprint) Screening   Yes  No
If yes, when/where:

TB Test   Yes  No
If yes, when/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
Do you have a copy of your Liability Insurance?	Yes  No
Do you have a copy of your Drivers License?	Yes  No
Do you have a Resume?	Yes  No
Do you have a copy of your credentials?	Yes  No
Do you have a completed W-9 form?	Yes  No

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.