Your First Name*
Your Last Name*
Fictitious Business Name
Are you certified by the Registry of Interpreters for the Deaf (R.I.D.), National Association of the Deaf (N.A.D.) or EIPA (levels 4-5)?
If yes, please list your certificates:
How long have you held your certification?
Are you Certified by any other organization?
If yes, please describe:
Have you completed an interpreter training program?:
Do you have proof of liability insurance?:
Can you submit a business license from city in which you are based?:
Please list three professional references:
Reference 1, Name and Phone
Reference 2, Name and Phone
Reference 3, Name and Phone
Please describe your present working situation
How long have you been interpreting and in what settings?
Please describe your schedule of availability
Please describe what geographical areas you can or do cover
Please describe your fee structure. Is this your best price?
Do you have any questions, comments, or other information you wish to share?
How did you hear about Partners In Communication? What made you decide to register?