Renewal Provisional-B Interpreter License Application

Your Info

Address

Mentor(s)

This section must be filled out for the class B provisional application


For your information:

Do you want to be listed independently on an interpreter directory?

If so, click here to go directly to web site and enter your information.

NOTE: This is a voluntary directory listing in which you can list your information for anyone to contact you.
This is separate from "current licensed" interpreter list.

Questionnaire

The following questions apply to your previous year only.

If you answer yes to any questions, please fill out the associated follow-up questions.

Have you been licensed/certified in another state or country during the previous year?

Has your license/certificate ever been subject to discipline during the previous year?
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Have you been denied a license/certificate to practice as an interpreter by a government licensing authority during the previous year?
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Have you been convicted of a felony or of an offense involving moral turpitude in this or any other state during the previous year?
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Have you been adjudicated insane or incompetent during the previous year?
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Has your State of Arizona Interpreter License or another jurisdiction certificate/license lapsed during the previous year?
Did you work in settings where licensure is required? (if not applicable, check No)

Has your State of Arizona Interpreter License or another jurisdiction certificate/license subject to a complaint during the previous year?
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Has your NAD/RID/BEI Certification (any type) lapsed during the previous year?
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Has your NAD/RID/BEI certification (any type) been subject to a complaint during the previous year?
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Are you a Citizen or National of the United States?

Per license rules, I will comply with the NAD-RID Code of Professional Conduct and Licensure rules.

Per license rules, I understand I am not permitted to work in a medical, mental health, platform or performance settings unless teamed with a Generalist or Legal licensed interpreter. I also understand that I am not permitted to work in legal settings under any circumstances. (A.R.S. R9-26-501)

Per license rules, I will maintain journals for teaming/mentoring and submit documentations upon renewal.

Statutory Information for the Reference of all applicants

Sec. 3. Section 41-1030, Arizona Revised Statutes, is amended to read:

41-1030. Invalidity of rules not made according to this chapter; prohibited agency action; prohibited acts by state employees; enforcement; notice

G. An agency shall prominently print the provisions of subsections B,D, E and F of this section on all license applications, except license application processed by the Corporation Commission.

B,D,E and F:

B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that specifically authorizes the requirement or condition.

D. This section may be enforced in a private civil action and relief may be awarded against the State. The court may award reasonable attorney fees, damages and all fees associated with the license application to a party that prevails in an action against the State for a violation of this section.

E. A State employee may not intentionally or knowingly violate this section. A violation of this section is cause for disciplinary action or dismissal pursuant to the agency's adopted personnel policy.

F. This section does not abrogate the immunity provided by section 12-820.01 or 12-820.02.S

Checklist Section

This is your guide to ensure you have included all documents by checking the below for completeness.

IF ITEMS ARE NOT SUBMITTED, YOU WILL BE ASKED FOR MORE DOCUMENTATION OR INFORMATION; DELAYING YOUR PROCESS.

Photocopies must be clear. Poor copies will be rejected.

To ensure completion of application is met, please check the following by submitting with this application:

• Documentation of name change if you applied under a name different from that on your documents (birth certificate, degrees, etc).

i.e.: Your last name is different than your current last name on any documentation

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• Submit proof of your 12 hours of continuing education hours with this renewal application - mandatory

Your 12 hours must be earned between your iicense issuance and expiration date.
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• Submit a copy of your journal from teaming or mentoring with this renewal application - mandatory

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• Submit payment of renewal fee of $25.00


Upgrading from C to B:

• Submit proof of your 500 hours of work experience earned while working with General or Legal licensed interpreter

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OR

• Submit proof of EIPA score of 4.0 on performance examination

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PAYMENT INFORMATION, MAILING ADDRESS & QUESTIONS

Payment can be made online, by check, money order, or cashier's check.

Make money order, cashier's check, or check payable to: Arizona Commission for the Deaf and Hard of Hearing or ACDHH , 100 N. 15th Ave, Suite 104, Phoenix, AZ 85007

Questions: contact Emmett Hassen at [email protected] - 480-264-0188 VP direct or Victoria Vaughn at [email protected] - 602-364-0986 V.

Uploaded Files

File For Name

By checking this box, I agree that all information in this application is true and that I will comply with all licensure statutes, rules and CPC.

By submitting this application, I agree that all information in this application is true and that I will comply when subjected with an audit, ALSO comply with the NAD-RID Code of Professional Conduct (CPC) Do you agree? Please e-sign below.