Office of Deaf and Hard of Hearing Services (DHHS)
Request for Approval of Proposed Training
for General and Court Interpreters Continuing Education Units (CEUs)
Form 3913
May 2017
[Statutory Authority: Texas Human Resources Code, Section 81.006(a)-(b)]
The Office of Deaf and Hard of Hearing Services must receive this form 30 calendar days before the date of
the training (for example, course, workshop, or seminar). The presenter or sponsor must complete the form
for each proposed training event each time the training is presented.
Training Information
Title of training:
Date(s) of training:
Starting time
Lunch break
Working lunch?
hr. hr. hr. min.hr.min. min. min.
Ending time
Day one Day two Day three Other day(s) if applicable
Yes No Yes No Yes NoYesNo
Name of training site: City:
Organization or sponsor:
Submitted by:
Email address: Telephone number:
Mailing address:
City:
State:
ZIP code:
Name of presenter(s):
TTY Voice Fax
Method of instruction:
Professional studies General studiesCategory of instruction:
Workshop Lecture or seminar Self-study or video study
Select type of provider: Types of interpreting skills targeted:
Employee training
Professional association Intermediary
SEECollege or university
ASL
School
Other
(specify):
Sign to Voice or Voice to Sign
Other
(specify):
Level of certification targeted:
Oral interpreting
Form 3913
Page 2 / 05-2017
Required Attachments for General and Court Interpreter Training
Attach a copy of the
course outline,
course narrative,
course handouts,
presenter's résumé showing education and interpreting experience,
course description and study schedule (for self-study or video study), and
conference agenda (if applicable).
Person(s) (Representatives) Authorized to Sign Certificates of Attendance
Signature: Printed name:
For HHS-DRS-DHHS Use Only
Approval granted:
reason:
Approval denied:
Contacted by:Database entry Letter sent
reason:
Approval pending:
Court CEU number: Credit units:
Approved by: Date:
Return this form and attachments to
Office for Deaf and Hard of Hearing Services
Attention: CEU Program
4900 North Lamar, Suite 2169, Austin, Texas 78751
P.O. Box 12904, Austin, Texas 78711
(512) 407-3250 Voice
(512) 407-3299 Fax
This application will be reviewed to ensure that it meets the court interpreter certification training criteria
found at Court Interpreter and Court Interpreter Mentor Training Course Options.
If you are requesting approval of training for court interpreters, please provide a copy of the presenter's
court interpreter certificate, lawyer's license, or paralegal's license.
Requirements for Court Interpreter Trainer
X
X