Regulated ProfessionsSign Language Interpreters for the DeafApplication Forms Attention Applicants: GUIDELINES FOR COMPLETING AND SUBMISSION OF THE APPLICATION THE APPLICATION MUST BE TYPED OR PRINTED BY HAND IN BLACK INK. The application is a part of the licensed interpreter's permanent file and at a later date will be electronically scanned. To insure accurate reproduction, the application form must be typed or printed in black ink. TEMPORARY LICENSE APPLICANTS: Please be aware that the temporary license will only be good for 90 days and that temporary licenses can only be issued once per year to an interpreter. SECTION I - APPLICATION INFORMATION - ALL APPLICANTS: When completing the NAME section, please use the following order: Last name, First name, Middle initial and Suffix such as Jr., III etc. Include a maiden in the appropriate section if applicable. The state committee is required to collect social security numbers. Please complete the enclosed Social Security Disclosure Notice. For date of birth please list month, day and year using numbers. For example a birth date of January 1, 1972 would be 01/01/1972. If the applicant uses a post office box, a street address is needed also. Employment setting - If the applicant is employed at a school district, for example, list the name and location. If the applicant works through a referral service, the name and address of the referral service needs to be entered on the application. Interpreters may have several sources of employment. Please list the primary place of employment. If the applicant is self-employed, enter self-employed in the section CURRENT PLACE OF EMPLOYMENT. SECTION II - CERTIFICATIONS Please indicate any and all applicable certifications that you hold and provide copies of your certification cards. SECTION III - EDUCATION List any college, university or professional school such as junior or community college that has been attended. Also, attendance dates can be listed by month and year. SECTION IV - ADDITIONAL INFORMATION If the applicant marks a YES in any of the questions, a brief explanation is required. The explanation must typed or printed in black ink on a separate sheet of paper, signed by the applicant and included with the application form. If the applicant fails to provide an explanation for a "YES" response, the state committee cannot process the application for review. SECTION V - STATEMENT OF APPLICANT Please read this section carefully and sign and date the application. Application Mentorship Application Mentorship Cover Page SSN Disclosure Notice FAQs