"Application to Pursue Court Interpreter Certification" - Mississippi

Application to Pursue Court Interpreter Certification is a legal document that was released by the State of Mississippi Judiciary - a government authority operating within Mississippi.

Form Details:

  • Released on November 1, 2001;
  • The latest edition currently provided by the State of Mississippi Judiciary;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the State of Mississippi Judiciary.

ADVERTISEMENT
ADVERTISEMENT

Download "Application to Pursue Court Interpreter Certification" - Mississippi

Download PDF

Fill PDF online

Rate (4.9 / 5) 7 votes
Page background image
State of Mississippi
Administrative Office of Courts
Court Interpreter Credentialing Program
Application to Pursue Court Interpreter Certification
TYPE or PRINT this Application in its entirety and return it along
Administrative Office of Courts
with the $100 non-refundable application fee (payable to AOC) to:
Court Interpreter Credentialing Program
Post Office Box 117
Jackson, Mississippi 39205
Name:______________________________ ________________________________ ___________________________
Last
First
Middle (Maiden)
Social Security Number:_______-_______-________
Date of Birth:___________________________
Mailing Address:
________________________________________________________________________________
_________________________________________________________________________________
Work Phone:_______________________Cell Phone:_______________________Home Phone:______________________
E-mail Address (required):______________________________________________________________________________
Education:____________________________________________________________________________________________
Language(s): I wish to pursue certification to interpret the following language(s):
1. _________________________________ 2. _____________________________ 3. ___________________________
Please attach separate sheet if additional space needed for any of the following questions:
Have you ever been convicted of a felony?
Yes____ No____
If yes, please give the crime(s) for which you were found guilty or pled guilty to, the jurisdiction, the date of
conviction(s), and circumstances surrounding the incident(s):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Have you ever been convicted of a misdemeanor, other than a traffic violation?
Yes ____ No____
If yes, please give the crime(s) for which you were found guilty or pled guilty to, the jurisdiction, the date of
conviction(s), and circumstances surrounding the incident(s):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Do you have a legal right to live and work in the United States?
Yes____ No____
Yes____ No____
Are you certified or do you hold any federal interpreting credentials?
Are you certified or do you hold any state interpreting credentials?
Yes____ No____
State of Mississippi
Administrative Office of Courts
Court Interpreter Credentialing Program
Application to Pursue Court Interpreter Certification
TYPE or PRINT this Application in its entirety and return it along
Administrative Office of Courts
with the $100 non-refundable application fee (payable to AOC) to:
Court Interpreter Credentialing Program
Post Office Box 117
Jackson, Mississippi 39205
Name:______________________________ ________________________________ ___________________________
Last
First
Middle (Maiden)
Social Security Number:_______-_______-________
Date of Birth:___________________________
Mailing Address:
________________________________________________________________________________
_________________________________________________________________________________
Work Phone:_______________________Cell Phone:_______________________Home Phone:______________________
E-mail Address (required):______________________________________________________________________________
Education:____________________________________________________________________________________________
Language(s): I wish to pursue certification to interpret the following language(s):
1. _________________________________ 2. _____________________________ 3. ___________________________
Please attach separate sheet if additional space needed for any of the following questions:
Have you ever been convicted of a felony?
Yes____ No____
If yes, please give the crime(s) for which you were found guilty or pled guilty to, the jurisdiction, the date of
conviction(s), and circumstances surrounding the incident(s):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Have you ever been convicted of a misdemeanor, other than a traffic violation?
Yes ____ No____
If yes, please give the crime(s) for which you were found guilty or pled guilty to, the jurisdiction, the date of
conviction(s), and circumstances surrounding the incident(s):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Do you have a legal right to live and work in the United States?
Yes____ No____
Yes____ No____
Are you certified or do you hold any federal interpreting credentials?
Are you certified or do you hold any state interpreting credentials?
Yes____ No____
If yes, please list the states and the dates you were credentialed: ____________________________________________
________________________________________________________________________________________________
(If applying for reciprocity, please fill out and return the Application for Reciprocity in addition to this form.)
Have you been denied certification or any federal or state interpreting credentials? Yes____ No____
If yes, please list states and reason for denial:
_________________________________________________________________________________________________
Have you ever been disciplined for violating any code of ethics for interpretation?
Yes____ No____
If yes, please explain:
_________________________________________________________________________________________________
The information I have provided in this application is true and correct to the best of my knowledge. I hereby authorize the
courts to conduct a thorough background check including but not limited to references, employment record, and criminal
record. I understand that all information will be kept confidential and released only to authorized individuals. I also
understand that any falsification of data on my part will result in disqualification to interpret in the Mississippi Courts. I
hereby release the courts from any civil or criminal liability arising from my background check.
_______________________
_____________________________________________________
Date
Signature of Applicant
State of _____________________________________
County of ___________________________________
Subscribed and sworn to before me this ________ day of _____________________, 20______.
My Commission Expires:____________
_____________________________________________
Notary Public
*This application must be completed and returned, along with payment of the application fee, to the Administrative Office
of Courts BEFORE you will be allowed to register for the written examination.
Administrative Office of Courts Form 11-01
Page of 2