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Fill and Sign the Language Access National Center for State Courts Form

Fill and Sign the Language Access National Center for State Courts Form

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STATE OF NEBRASKA’S JUDICAL BRANCH COURT INTERPRETER PROGRAM AUTHORIZATION TO CONDUCT CRIMINAL BACKGROUND CHECK AND INVESTIGATION As an applicant to the Nebraska Supreme Court Interpreter Program, I authorize the Nebraska Administrative Office of the Court (AOC) to conduct a criminal background check and investigation. By completing, signing and returning this form to the AOC, I understand and agree that the AOC and its designees may conduct a criminal background check and investigation, as well as seek any further information regarding my character, qualifications and/or work performance. Please print or type the following information and sign the authorization: FULL NAME: ALIAS/AKA (other names used such as maiden, married, adopted, nicknames, short names, etc.): SOCIAL SECURITY NUMBER: DRIVER LICENSE OR STATE IDENTIFICATION NUMBER: DATE OF BIRTH: SEX: RACE: CITY: STATE: ZIP CODE: TELEPHONE (home): TELEPHONE (cell): CURRENT ADDRESS: DATE: SIGNATURE: Please forward this completed authorization form to: Nebraska Administrative Office of Courts ATTN: Trial Court Services Director P.O. Box 98910 Lincoln, NE 68509 NSC.Courtservices@nebraska.gov THIS FORM IS TO BE COMPLETED AND SUBMITTEED ONLY AFTER THE APPLICANT HAS SUCCESSFULLY COMPLETED THE REQUIREMENTS TO BECOME A NEBRASKA COURT INTERPRETER. Internal Use Only Report Requested By: ______________________________________ Date: __________________ AD 2:07 New 04/2014

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Language access services in healthcare
National Center for interpretation
National Center for State Courts Conference
National Center for state courts training
Language Access Programs by State
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National Center for Court management
State Courts written examination

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