Fill and Sign the Front Matter the Council of State Governments Form

FOREIGN LANGUAGE INTERPRETER APPLICATION REGISTRATION FORM INS TRUCTIONS All foreign language interpreters providi ng services in Alabama’s courts must now register with the Alabama Administrative Office of the Courts (AOC) by completing, signing and returning the attached Registration Form to the AOC. Upon reviewing the Registration Form and conducting a successful background check, the AOC will send the registered interpreter additi onal information regarding et hical and professional conduct, and interpreter qualifications and certification. The AOC will list each eligible register ed foreign language interpreter on an AOC Foreign Language Services Registry. This Registr y will be made available to all judges, attorneys and to the general public. To remain eligible as a registered interpreter and listed on the AOC FLS\ Registry, the interpreter shall meet all interpreter requirements established by law or rule; shall abide by all ethical and pr ofessional behavio r policies; and shall meet and abide by the qualification and certificati on policies and procedures es tablis hed by the Alabama Administrative Office of Courts. This form is for interpreter foreign l anguage registration only. Any application for interpreter orientation, education and/ or testing will be by separate form. By completing, signing and returning this registration form to the Alabama Ad ministrative Office of Courts, the interpreter understands and ag rees that the AOC will conduct a criminal background check, and may seek further information regarding the interpreter’s character, qualific ations and work per formance. Foreign Language Interpreter Application Registration Form ADMINISTRATIVE OFFICE OF COURTS 1 Note: A felony conviction will bar employment in law enforcement and cer\ tain judicial positions. The disclosure of a misdemeanor will not automatically result in disqualification from employment. Criminal histories will be submitted t\ o the National Crime Information Center (NCIC) for verification. Failu\ re to disclose a conviction may be considered grounds for disqualification. For these reasons, appli\ cants should be careful to disclose ALL criminal convictions. Courr PART I. – IDENTIFICATION Social Security Number Last Name First Name M.I.Area Code Phone Numbers Cell: Work: Mailing Address (Street Number / Name , Apt. Designation or RFD City County State Zip Code Are you currently working within the Unified Judicial System? \ Yes No E-mail Address: ___________________________________________ PART II. – INDICATE ANSWER BY PLA CING AN “X” IN THE PROPER BOX 1. Have you ever been discharged or forced to resign from a position? Yes No Please be advised that inquiries may be made of your present and/ or past employers regarding character, qualif ications, or work performance . 2. Have y ou ever been convicted of a crime other than a “minor” traffic offense? If yes, explain charges, w here convicted and dates below. Yes No ________________________________________________________________________\ ___________________________ ____________________________________________________________________\ ______________________________________________ 3. List 5 Alabama counties where you are primarily interested in providing interpreter services. 4. Would you be willing to provide interpreter services requiring overnight\ travel? Yes No 1. 2.3. Items below to be completed by Administative Office of Courts PART III. EDUCATION AND CERTIFICATIONS – Give Your Complete Educational History Did you graduate from high school or pass the high school equivalency test? Check your answer Yes No DATES From To LEVEL NAME & LOCATION Mo. Yr. Mo. Yr. YEAR of COMPLETION CRED. HOURS DID YOU GRAD? DEGREE OR DIPL. & DATE MAJOR SUBJECT Elementary or High School College Graduate or Professional Other Education, Intern., etc. 1. List all langauges for which you are licensed, registered, or certifi ed to translate or interpret, and the authorizing agency . RETURN TO: AOC Legal Division 300 Dexter Avenue Montgomery, AL 36104-3741 State of Alabama U.J.S. Form 2. Which language would you prefer to translate or interpret? _______________________________________________________________________ Foreign Language Interpreter Program PART IV. – EMPLOYMENT – This section must be completed even if a resume is attached. Registration for UJS Foreign Language Interpreter Services Answer questions for each period of employment; include previous employment with the State of Alabama, military service, and re lated volunteer work. Begin with your present or l ast position. Starting A. Title of present or most recent position ______________________________\ ____________ Salary _____________Last Salary__________ ` Name & Title of supervisor __________________________________ No. emp. superv. by you ___________ Employer __________________________ Address _____________________________________________ Duties _________________________________________________________________\ _________________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ Reason for leaving ____________________________________________________\ ___________________ Date employed Date separated Full-time Yrs. Mos. Part-time Yrs. Mos. If part-time, no. of hrs. worked /wk. Starting B. Title of next most recent position _____________________________________\ __________ Salary _____________Last Salary___________ __ Name & Title of supervisor __________________________________ No. emp. superv. by you ___________ Employer ______________________________ Address_____ _____________________________________ Duties _________________________________________________________________\ ________ _________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ Reason for leaving ____________________________________________________\ ___________________ Date employed Date separated Full-time Yrs. Mos. Part-time Yrs. Mos. If part-time, no. of hrs. worked /wk. Starting C. Title of next most recent position _____________________________________\ __________ Salary _____________Last Salary___________ Name & Title of supervisor __________________________________ No. emp. superv. by you ___________ Employer _____________________________ Address ___________________________________________ Duties _________________________________________________________________\ _________________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ ________________________________________________________________________\ _______________ Reason for leaving ____________________________________________________\ ___________________ Date employed Date separated Full-time Yrs. Mos. Part-time Yrs. Mos. If part-time, no. of hrs. worked /wk. CERTIFICATION AND CONDITION OF CERTIFICATION I certify that the statements on or attached to this application are tru\ e and correct to the best of my knowledge. I know that any false statements may cause me to be denied registration or certification, the opportunity for testing, or to be removed from an interpreter register. I authorize the release of all prior employment, military service, acade\ mic/school and criminal records and authorize the A.O.C. to contact my present and past employers regarding my character, qualif\ ications and/or work performance. I also understand and agree that foreign langauge interpreters shall be compensated pursuant t\ o Alabama's law and rules. Date ____________________________________ Applicant’s Signature : _____________________________________________\ ___ State of Alabama U.J.S. Form 2 \ \ State of Alabama U.J.S. Form 3 Yes (X) No (X) AVAILABILITY SCHEDULE DAY SUN MON TUES WED THUR FRI SAT HOURS: from Do you have a valid Alabama driver’s license? If yes, the driver’s license # is ________________ _ HOURS: to Are you fluent in speaking the English language? Are you associated with/related to anyone in the Alabama Court System? GIVE DETAILS (use additional paper, if necessary) Have you ever provided foreign GIVE DETAILS (use additional paper, if necessary) language interpreter services in Alabama's courts? HOW DID YOU LEARN ABOUT OPPORTUNIT IES FOR PROVIDING FOREIGN LANGUAGE INT. SERVICES IN ALABAMA'S COURTS? WOULD YOU CONSIDER AN OPPORTUNITY TO WORK FULL-TIME OR PART-TIME AS A CERTIFIED FOREIGN LANGUAGE INTERPRETER FOR ALABAMA'S COURTS? CHARACTER REFERENCES (exclude relatives) NAME ADDRESS TELEPHONE NUMBER S P E C I F I C P R O G R A M I N F O R M A T I O N CERTIFICATION AND CONDITION OF CERTIFICATION I certify that the statements on or attached to this application are tru\ e and correct to the best of my knowledge. I know that any false statements may cause me to be denied registration or certification, the opportunity for testing, or to be removed from an interpreter register. I authorize the release of all prior employment, military service, acade\ mic/school and criminal records and authorize the A.O.C. to contact my present and past employers regarding my character, qualif\ ications and/or work performance. I also understand and agree that foreign langauge interpreters shall be compensated pursuant t\ o Alabama's law and rules. Date ____________________________________ Applicant’s Signature : _____________________________________________\ ___ LAUD ER DA LE MAD ISON LIM EST ON E C O LB ER T LA W REN CE MORGAN MARSHA LL D E KA LB W IN ST ON BLOUN T ET OW AH C H ER OK EE C LEB URN E C A LHOUN S T C LA IR J EFFE RSON F AY ETTE LA MAR P IC KEN S T U SC A LOO SA SH ELB Y T A LLAD EGA CLAY R ANDO LPH C HA MBER S T A LLA POO SA C OO SA C H ILT ON B IBB S U M TE RG REE NE HALE PERR Y AUTAUGA EL MORE M ARENGO LO W ND ES M ACON M ON TGO MER Y W ILCOX R U SSELL B A RB OU R CR ENSHA W B U TLER M ON RO E ES CA M BIA C OV ING TON GEN EVA C O FFEE DA LE C LA RK E W ASH ING TON M OBILE BA LD W IN H EN RY HOU ST ON P IK E LEE W ALK ER F R ANK LIN C HO CTA W B U LLO CK C ON ECUH C U LLM AN M ARION J A CK SON DA LLA S Ala b am a C oun ties Produ ced by the Dept. of Geography Coll ege of Arts and Sci ence s The Uni versity of Alabam a