Deprecated: mysql_pconnect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /home1/alsglob1/public_html/Registration/DAL/DaoBase.php on line 32

Warning: mysql_pconnect(): Access denied for user 'rootadmin'@'localhost' (using password: YES) in /home1/alsglob1/public_html/Registration/DAL/DaoBase.php on line 32

Warning: mysql_select_db() expects parameter 2 to be resource, boolean given in /home1/alsglob1/public_html/Registration/DAL/DaoBase.php on line 33

Strict Standards: Only variables should be passed by reference in /home1/alsglob1/public_html/Registration/Wizard2.php on line 22
American Language Services ® - Interpreter's Order Form
PERSONAL
Type of vendor:  Individual  Team  Agency
Company Name:
Title (Mr. /Mrs. /Ms.):
First Name:
Last Name:

Address:
 Suite/Apt.:
City: Zip/Postal code:
State:
County/Region:
Province:
Country:

Email:
Email (Alternate):
Web Site:

Please, input all digits in following order: country code + area code + number.
Telephone (daytime): - -
Cell Phone: - -
Telephone (evening): - -
Fax: - -
ATTRIBUTES
Nationality: Native Language:

What languages do you interpret? ( Please, select all that apply).

Clear All

What services do you offer? ( Please, select all that apply).
Simultaneous: Consecutive:
Both Simultaneous
and Consecutive:
Focus Groups:
Translation: Transcription:
Voice-over: Captioning:
Dubbing: Other (please specify):

What is your specialization? ( Please, select all that apply).
Legal: Medical:
Technical: Scientific:
Focus Groups: Conferences:
Tours: Other (please specify):
AVAILABILITY
Days? Hours (Pacific Time) From: Until:

Evenings? Hours (Pacific Time) From: Until:

Weekend? Hours (Pacific Time) From: Until:
COVERAGE AREA
Domestic (US) Primary Area Secondary Area

City:

County:
State:

Are you willing to travel?
Domestically?  Yes  No   Internationally?  Yes  No

International Primary Area Secondary Area

City:

Country:
QUALIFICATIONS & EXPERIENCE
Degree: Membership in professional organizations:

How many years of experience do you have in interpretation?

Certification ( Please, input all that apply).
CA State Certified, # Court-approved, #
State Certified, # Conference, #
Federal Certified, # Court-registered, #
Medical Certified, # Notes area:
RID Certified, #
CA Admin Hearing Certified, #
CA Court Registered, #

American Sign Language (ASL): # Level
RATES
Note: Please quote rates in US Dollars. If rates vary by language, please specify language rates differences in the notes area below.
Standard Rate (per hour): $
Notes area:

Half-day Rate (per hour): $ Number of Hours:

Full-day Rate (per hour): $ Number of Hours:

Overtime Rate, (if applicable, per hour): $

Other:    $   Description:    
REFERRALS
Do you have any associates you would like to refer:
1 Full Name: Telephone: -
Email:

2 Full Name: Telephone: -
Email:

3 Full Name: Telephone: -
Email:
ATTACHMENTS
Please click here to attach your resume/CV
Please click here to attach a list of references
Additional Comments:

Add the numbers and put result below
Please Submit only One Time

Interpretation, translation, and transcription specialists offering professional, worldwide multi-language services to every industry.