Name of
Organization/Employer
Address
Employed
From To
Month/Year Month/Year
Title & Duties
Interpreting/Translating Experience (attach additional sheets, if necessary):
Are you currently an employee of the NYS Unified Court System? Yes No
How did you hear about this opportunity:
NYS courts website
From an employee of the
NYS court system
Courthouse
Print Ad (newspaper, magazine)
Career fair at a college
(please specify):
Freelance interpreter
Public Service Announcement
Other (please describe):
Except for adjudications as youthful offender, wayward minor, or juvenile delinquent,
have you ever been convicted of a misdemeanor or felony? Yes No
Do you have any criminal charges pending against you? Yes No
Have you ever been dismissed from any employment? Yes No
Have you ever received a discharge from the Armed Forces that
was other than honorable? Yes No
Are you currently in violation of a court order in any state for
child or spousal support? Yes No
Have you ever been disciplined by, or are charges presently pending before,
any agency authorized to bring disciplinary proceedings related to the
practice of any profession? Yes No
If your answer is ‘yes’ to any of the above questions, please provide details on a separate sheet.
SPECIAL ARRANGEMENTS FOR THE LANGUAGE SKILLS SCREENING EXAMS:
Check below if you need special arrangements:
Sabbath observer and for religious reasons cannot be tested on Saturdays.
Special arrangements (such as ADA accommodation required) in order to take this exam.
PLEASE COMPLETE THIS AFFIRMATION
I affirm that the statements made on this application (including any attached papers) are true. [False statements
made in this application are punishable under Penal Law (§210.45) and may result in your disqualification.]
Signature of Applicant Date
(OLA 04/2015)
Once completed, mail this application to the address noted on page 1
THE STATE OF NEW YORK UNIFIED COURT SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER
