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REQUEST DETAILS

First Name *

Last Name *

Area Code and Mobile Number *

Email Address *

Company (if applicable)

Preferred Contact Method *Select all that apply.EmailPhone Call & VoicemailWhatsApp MessageText Message

Type of Inquiry *

Message *How can we help you?0 / 250

How did you find us? *

REQUEST QUOTE

Select Service *InterpretationInterpretation TrainingTranslationTranscriptionVoiceoverSubtitlingDubbingOther Service

Additional NotesAnything else?0 / 250

First Name *

Last Name *

Area Code and Mobile Number *

Email Address *

Company (if applicable)

Disclaimers

(1) Use UPPERCASE for all ticket submissions.

(2) Double-check spelling and accuracy.

(3) Incorrect invoices will not be paid until corrected.

(4) A Purchase Order (PO) will be provided on the assignment date via WhatsApp.

(5) Send parking &/or toll itemized receipts to contact@prisma-international-corporation.com with the PO in the subject line.

(6) Invoices will be paid on the 20th of each month for the prior month’s work.

(7) Allow up to 3 business days for the deposit to reflect in your bank account.

(8) Payroll checks (if any) are mailed from our RDU office via USPS. Delivery dates are not guaranteed.

(9) You’ll be notified if errors are found in the invoice.

(10) Missing invoices will not be paid until submitted.

(11) Text the dispatch team the workflow of your appointment:

On route
Interpreter has checked in with front desk
Client has checked in for the appointment
Assignment has ended

Interpreter's Full Name *

PO# / Word Order Number / Assignment *

Appointment Date *MM/DD/YYYY

ARRIVAL Time (Interpreter) *HH:MM AM/PM

START Time (Session) *HH:MM AM/PM

END Time (Appointment) *HH:MM AM/PM

Assignment Address *with City, ST, Zip Code

Troubleshooting Menu *

Client Dispatch REPRESENTATIVE Name for Release *

PHI Notes *Provide PHI notes without violating HIPAA (releasing PHI) information. All invoices are paid on the 20th of each recurring month, for the previous month.

SUBMIT INVOICE

PARTNER WITH US

Enroll as an Independent Contractor

Disclaimers

According to the GDPR, our international business handles personal data from NOAM, LATAM, and EMEA internal and external stakeholders, required to make certain disclosures in our privacy policy. By completing this form, you give explicit and informed consent for us to process your information.

We follow GDPR’s data protection and accountability principles:

Data processing is fair to the data subject.
Data is only be processed for specific and legitimate purposes, outlined in your privacy policy.
We don’t collect more data than we need.
We make sure the data we collect is accurate.
We do not store personal data longer than needed for the specified purpose.
We process data in a way that ensures security, integrity, and confidentiality.
We can demonstrate compliance with these principles.

I want to enroll as an independent contractor *Spoken Language Interpreter(ASL) American Sign Language Interpreter

First Name *Enter legal first name as it appears on your state-issued ID).

Middle Name *Enter legal first middle (as it appears on your state-issued ID), not just the initial.

Last Name *Enter legal last name (as it appears on your state-issued ID).

SexSome urology and OB-GYN clinical appointments require sex-specific interpreters to be assigned. Voluntarily disclose your sex for assignment allocation.MaleFemalePrefer not to disclose

Date of Birth *U.S. format (month/date/year)

Email Address *Enter your preferred email for assignments and inquiries.

Cell Phone Number *Enter your U.S. cell phone number for calls, texts, and WhatsApp messages.

Preferred Contact Method *Select all that apply.EmailPhone Call & VoicemailWhatsApp MessageText Message

Address Line 1 *Enter your residential house number and street name.

Address Line 2Enter your residential apt/unit number.

U.S. City *Enter your residential city.

U.S. State *Enter your residential state.

U.S. Zip Code *Enter your residential zip code.

Education *Select the highest level of educational achievement completed (documented).High School / GEDNon-degree Programs (Vocational/Technical Certificates)Associate's Degree (AA/AS)Bachelor's Degree (BA/BS)Master's Degree (MA/MS/MBA)Phd / EdD / JD / Other Doctoral Degree

Certifications *What other credentials or certifications do you hold aside from your degree? Select all that apply.Certified Translator (CT) by ATACoreCHICHIHub-CMICMIState Court Certified (U.S. only)Federally Certified Court Interpreter (FCCI)None, I am not certified or partially certified nor credentialed.

If you are not certified (CHI/CMI, Court, or FCCI), which of these 40-hr minimum-required interpretation basic training did you complete?Bridging the Gap 40-HrBridging the Gap 64-HrThe Community Interpreter 40-HrNone. I have not been trained as a professional and qualified interpreter and I need information about it.

Certifications *What other credentials or certifications do you hold aside from your degree? Select all that apply.Certified Deaf Interpreter (CDI)Certificate of Interpretation (CI)Conditional Legal Interpreting Permit-Relay (CLIP-R)Comprehensive Skills Certificate (CSC)Educational Certificate: K-12 (Ed:K-12)Educational Interpreter Certificate (EIC)Emergency Temporary Certificate (ETC)Interpretation Certificate (IC)Interpretation/Transliteration Certificate (IC/TC)Master Comprehensive Skills Certificate (MCSC)National Association of the Deaf III (NAD III)National Association of the Deaf IV (NAD IV)National Association of the Deaf V (NAD V)National Interpreter Certification (NIC)NIC AdvancedNIC MasterOral Interpreting Certificate: Comprehensive (OIC:C)Oral Interpreting Certificate: Spoken to Visual (OIC:S/V)Oral Interpreting Certificate: Visual to Spoken (OIC:V/S)Oral Transliteration Certificate (OTC)Provisional Special Certificate: Legal (Prov. SC:L)Reverse Skills Certificate (RSC)Special Certificate: Legal (SC:L)Special Certificate: Performing Arts (SC:PA)Transliteration Certificate (TC)Other

If you are not an RID-certified ASL interpreter, which basic ASL interpretation training did you complete? *

Preferred Mileage Range *Select the (one-way) mileage you are willing to drive for a single assignment.Up to 50 milesUp to 75 milesUp to 100 milesUp to 150 milesGreater than 150 miles

Out-of-State Assignments *Are you willing to take assignments out of state?
Vehicle | Prisma reimburses round-trip mileage when you drive.
Flight | Prisma handles the logistics when you fly.Yes, but only neighboring states.Yes, any U.S. state (Continental U.S.).Maybe (depending on the location or assignment)No

Transportation *Prisma only assigns appointments to independent contractors who have reliable transportation. Prisma does not reimburse share rides (Uber, Lift, Taxi, or similar services).I confirm I own reliable transportation.I confirm I use public transportation (metro areas only).

Accommodation RequirementAre you able to perform the essential functions of the assignment, with or without reasonable accommodation?
Prisma International Corporation is an EEO employer. The law requires an employer to provide reasonable accommodation to an employee or job applicant with a disability (ADA) unless doing so would cause significant difficulty or expense for the employer ("undue hardship").Yes, I can perform the job/deliver the assignment without special accommodations.No, I need special accommodations to perform the job/deliver the assignment.

Voluntary Minority Disclosure *Are you a minority applicant?
Prisma International Corporation is a MBE - Minority Business Enterprise Certified Small Business.
A "minority applicant" in the US employment context refers to an individual who belongs to one of these racial or ethnic groups that have historically been underrepresented or subjected to discrimination in the workforce, and who is therefore protected under equal employment opportunity laws.American Indian or Alaska Native: A person with origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.Asian: A person with origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent (e.g., China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam).Black or African American: A person with origins in any of the black racial groups of Africa.Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.Native Hawaiian or Other Pacific Islander: A person with origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.Two or More Races: Persons who identify with more than one of the above racial categories.I prefer not to disclose.No, I am not considered a minority applicant in the U.S.

Veteran Status Disclosure *Select the category that best describes your veteran status. These categories are mandated by the Vietnam Era Veterans’ Readjustment Assistance Act (VEVRAA) and enforced by the Office of Federal Contract Compliance Programs (OFCCP).I am a protected veteran.I am not a protected veteran.I am not a veteran.I prefer not to disclose my veteran status.

Voluntary Disability Disclosure *Indicate if any of the following apply.

Disabilities Listed on the EEOC Voluntary Self-ID Form:
- Alcohol or other substance use disorder (not currently using drugs illegally)
- Blindness or low vision
- Cancer
- Cardiovascular or heart disease
- Celiac disease
- Cerebral palsy
- Deafness or serious difficulty hearing
- Diabetes
- Disfigurement (for example, severe disfigurement caused by burns or accidents)
- Epilepsy or other seizure disorder
- Gastrointestinal disorders (e.g., Crohn’s Disease, irritable bowel syndrome)
- HIV or AIDS
- Intellectual or developmental disability
- Missing limbs or partially missing limbs
- Mobility impairment (e.g., using a wheelchair, walker, or cane)
- Major depressive disorder
- Obsessive compulsive disorder
- Post-traumatic stress disorder (PTSD)
- Pulmonary or respiratory conditions (e.g., asthma, COPD)
- Schizophrenia or schizoaffective disorder
- Spinal cord injury
- Traumatic brain injury (TBI)
- Other disability or serious health condition

Public Burden Statement:
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number.Yes, I have a disability, or have had one in the past.No, I do not have a disability and have not had none in the pastPrefer not to disclose

Assignment Preferences *Select all that apply.Medical Interpreter: Primary Care, Urgent Care, Specialty Clinics, Hospitalizations, Dental Care, Mental Health and Rehabilitation ServicesLegal Interpreter: Depositions, Attorney-Client Meetings, Document Sight Translations, Workers’ Compensation CasesCourt Interpreter: Hearings, Proceedings, Trials, Immigration (USCIS), Industrial CommissionGovernment Interpreter: City Council, Local Government, Child Protective Services (CPS), Department of Homeland Security (DHS), Department of Health and Human Services (DHHS), Federal Emergency Management Agency (FEMA), etc.Educational Interpreter: Classroom, Assessments, State Testing, Psychological Evaluations, IEP/504/PTA Meetings, Sight TranslationsReligious Interpretation: Sermons, Prayers, Pastoral Care, Live Interpretation in a church setting or eventCommunity Interpreter: NPO, Health Fairs, Home Visits, Legal Clinics, Homeless Outreach, Shelters, Environmental, Voting Support, Refugee Settlements, othersSports and Entertainment: UFC Interpreter, MLB Interpreter, World Cup Interpreter, Miss Universe Interpreter, MLS Interpreter, Television Broadcasts, NewsBusiness Interpreter: Simultaneous Interpretation for corporate meetings, Conventions, Trade Shows, Employee Meetings, Training Services, Delegations, Negotiations, and Escort Interpretation

Are you a Prisma International Corporation recent BTG graduate (Bridging the Gap) eligible for the $5.00 USD bonus per assignment differential? *This is our thank you and give back, to maximize your investment by taking the class with us.Yes, I completed the BTG program at Prisma International Corporation.No, I want to learn more about the bonus pay.

Do you have a referral for Prisma’s paid referral network? *Prisma International Corporation pays a one-time referral fee for each referral you submit when they complete their first assignment. We request referrals for any language, in any U.S. state and its territories.
You’ll be notified if they join our network and are successfully booked through our referral system.Yes, I have a referral.No, I do not have a referral.

Referral First Name *

Referral Last Name *

Referral Mobile Number *

Referral Email Address *

If requested by the client, can you provide proof of COVID-19 vaccination, particularly for assignments in hospital or medical settings? *Some clients require proper vaccination records for onsite assignments.
NOTE: Prisma International Corporation does NOT require vaccination records, although clients may ask for such records for compliance audits.Yes, I can provide proof of vaccination.No, I cannot provide proof of vaccination.

What language combinations are you proficient in other than English (C1/C2 level, 4-5: Professional, Fluent, or Native)? *

Education *What is your highest level of education completed for which you can provide documentation?High School / GEDAssociate's DegreeBachelor's DegreeMaster's DegreePhD / Post Doctoral / JDOther Vocational Education (Certificates)Other

Are you eligible to work legally in the United States and without sponsorship? *YesNo

What level of work authorization do you currently have for the U.S. market? *U.S. Citizen, able to work for any employerU.S. Resident alien with work authorizationF1/Student Visa, or OPT Applicant, TN visaOther

What is your availability and/or preference to take onsite assignments? *Select all that apply.AnytimeMornings — 06:00 AM - 12:00 PMAfternoons — 12:00 PM - 06:00 PMOvernight — 06:00 PM - 08:00 AMWeekendsHolidays

Have you ever been convicted of a crime, felony, or misdemeanor, even if it is a minor traffic violation? *YesNo

Explain the circumstances of your conviction(s) *0 / 250

Under penalty of perjury, are you listed in any of the following exclusion lists? *- Federal List of Excluded Individuals and Entities
- Federal System for Award Management (SAM), formerly EPLS
- Any U.S. state exclusion listNo, I am not listed in any of the abovementioned entities.Yes, I am excluded from working in at least one of the agencies listed.

Which one? Explain. *0 / 250

What is your hourly rate for interpretation services, ad-hoc PRN (Per Request Needed) assignments? *Include $XX.XX amount per hour.

What is your discounted hourly rate for interpretation services for assignments that are B2B, half-days, full-days, multi-day shifts? *Include $XX.XX amount per hour.

What is your mileage rate for ad-hoc PRN (Per Request Needed) assignments? *Include $XX.XX amount per incurred mile.

Terms and Conditions *Prisma has a standard 24-hour cancellation policy. What other terms and conditions would you like to share to be considered as a vendor? Include minimum number of hours to cover an assignment (clinical, hospital, legal, etc).0 / 250

Payment Policy

Prisma International Corporation does not pay a premium rate after hours, rush fees, travel time, holiday pay, differential, or overtime. Appointments are for single individuals, not teams, as we do not charge the clients any of these fees. We reimburse only for mileage roundtrip, parking, and tolls at cost (with itemized receipts). We do not pay for travel time, valet parking, ride shares (Uber, Lyft, etc.). Our payroll cycle is on the 20th of each month, covering services rendered in the previous month. All our payments are via ADP/direct deposit.

Do you have proof of insurance? *An ACORD certificate of insurance with a $1,000,000 USD minimum coverage for professional and/or general liability is required to enroll as a B2B/C2C vendor.Yes, I am fully insured and can provide proof of insurance for my business.No, I am not ensured, but I will be procuring insurance before my first assignment.No, I am not insured / my business is not insured.No, I am an individual and do not have insurance.

By submitting this application, I certify that all information provided is accurate and complete to the best of my knowledge. I understand that any false or misleading information may result in my disqualification from employment or termination of contract. I acknowledge that providing false information could result in legal consequences under penalty of perjury. *

Yes, I certify that all information provided is true and complete to the best of my knowledge.

Which position are you interested in? *Bilingual Associate (will enroll at Prisma training, within 3 months from contract issuance)Qualified Interpreter (will have trained formally with a 40-hr minimum certificate program)Partially Certified Interpreter (Hub CMI, CoreCHI)Fully Certified Interpreter (CMI, CHI)Court or Federally Court Certified (State, FCCI)

File Uploads

Upload your CV and any formal interpreter education credentials when submitting your application. After submission, our HR/Vendor Enrollment team will email you a list of additional items needed to complete your provider profile. If you have any questions about this form or the next steps, feel free to contact us at hr@prisma-international-corporation.com.

CV - Resume *

No file chosen

Formal Interpretation Certificate of Successful Completion (40-hr minimum)

No file chosen

Proof of Certification

No file chosen

Enroll as an Agency (B2B)

Disclaimers

We follow GDPR’s data protection and accountability principles:

Data processing is fair to the data subject.
Data is only be processed for specific and legitimate purposes, outlined in your privacy policy.
We don’t collect more data than we need.
We make sure the data we collect is accurate.
We do not store personal data longer than needed for the specified purpose.
We process data in a way that ensures security, integrity, and confidentiality.
We can demonstrate compliance with these principles.

Agency/Business Name *(as it appears on your state-issued Article of Incorporation)

Billing Email Address *(for assignments and communications)

Business Phone Number *format: XXX-XXX-XXXX

Preferred Contact Method *Select all that apply.EmailPhone Call & VoicemailWhatsApp MessageText Message

Business Address Line 1 *House Number and Street Name

Business Address Line 2Apt/Unit Number

City *

State/Province *

ZIP / Postal Code *

Country *

Service range for assignments *Select the (one-way) mileage you/your interpreters are willing to drive for a single assignment.Up to 75 milesUp to 100 milesUp to 150 milesGreater than 150 miles

Are you/your interpreters willing to take assignments out of state? *YesNo

For multi-days/shift assignment, are you/your interpreters willing to fly out of state for assignments? *YesNo

Do you/your interpreters have reliable transportation to take onsite assignments? *YesNo

Is your organization able to perform the essential functions of the assignment, with or without reasonable accommodation? *Prisma International Corporation is an EEO employer. The law requires an employer to provide reasonable accommodation to an employee or job applicant with a disability (ADA) unless doing so would cause significant difficulty or expense for the employer ("undue hardship").Yes, our organization can perform the job/deliver the assignment without special accommodations.No, our organization needs special accommodations to perform the job/deliver the assignment.

Are you a minority business enterprise (certified MBE)? If so, can you provide proof of your MBE certification? *Prisma International Corporation is a MBE - Minority Business Enterprise Certified Small Business.YesNo

Areas of service, preferred assignment type(s) *Select all that apply.Medical Interpreter (Primary Care, Urgent Care, Specialty Clinics, Hospitalizations, Dental Care, Mental Health and Rehabilitation Services)Legal Interpretation (Lawyers' office, depositions)Court Interpreter (Hearings, Proceedings, Trials, Immigration) for Civil, Criminal, or Corporate Cases like Workers’ CompensationGovernment Interpreter (USCIS Immigration cases, Child Protective Services (CPS), Department of Health and Human Services (DHHS), Federal Emergency Management Agency (FEMA), etc.)Educational InterpreterReligious Interpretation (Church/faith-based)Community Interpreter (Non-profit organizations, etc.)Sports and Entertainment (UFC Interpreter, MLB Interpreter, World Cup Interpreter, Miss Universe Interpreter)Business Interpreter (Simultaneous interpretation for corporate meetings, conventions, trade shows, employee meetings, training services, delegations, and negotiations)

Are you/your interpreters eligible to work legally in the United States without sponsorship? *YesNo

What is your agency availability and/or preference to cover assignments? *Select all that apply.AnytimeMornings — 06:00 AM - 12:00 PMAfternoons — 12:00 PM - 06:00 PMOvernight — 06:00 PM - 08:00 AMWeekendsHolidays

Under penalty of perjury, are you listed in any of the following exclusion lists?- Federal List of Excluded Individuals and Entities
- Federal System for Award Management (SAM), formerly EPLS
- Any U.S. state exclusion listNo, none of our staff or vendors are listed under any of the abovementioned entities.Yes, our organization (or an associated staff member or vendor) is excluded from working in at least one of the agencies listed.

What is your discounted B2B / C2C interpretation service hourly rate for interpreting for ad-hoc PRN (Per Request Needed) assignments? *Include $XX.XX amount per hour.

What is your discounted B2B / C2C mileage rate for assignments this fiscal year? *

Terms and Conditions *Prisma has a standard 24-hour cancellation policy.
What other terms and conditions would you like to share to be considered as a vendor? Include minimum number of hours to cover an assignment (clinical, hospital, legal, etc).0 / 250

Payment Policy

Prisma International Corporation does not pay a premium rate after hours, rush fees, travel time, holiday pay, differential, or overtime. Appointments are for single individuals, not teams, as we do not charge the clients any of these fees. We reimburse only for mileage roundtrip, parking, and tolls at cost (with itemized receipts). We do not pay for travel time, valet parking, ride shares (Uber, Lyft, etc.). Our payroll cycle is on the 20th of each month, covering services rendered in the previous month. All our payments are via ADP/direct deposit.

Requirements for B2B Subcontractor Enrollment *If you provide an EIN# rather than a SSN#, you are considered a B2B (Business to Business) subcontractor. You will be required to provide proof of insurance coverage for General Liability and/or Errors and Omissions for Professional Liability insurance with a $1,000,000 USD minimum (per claim) in insurance coverage for professional and general liability. An ACORD certificate of insurance, a business license or Article of Incorporation may be required to enroll you as a B2B vendor. Can you provide proof of insurance?Yes, I am fully insured and can provide proof of insurance for my business.No, I am not ensured, but I will be procuring insurance before my first assignment.No, I am not insured / my business is not insured.

Yes, I certify that all information provided is true and complete to the best of my knowledge.

File Uploads

Provide a copy of your business files required below. The HR / Vendor Enrollment team will provide a list of items to complete your Provider profile via email. Contact hr@prisma-international-corporation.com if you have questions about this form or next steps.

Secretary of State - Article of Incorporation *

No file chosen

ACORD Certificate of Insurance *

No file chosen

Partner Program

Full Name *

Email Address *

Area Code and Mobile Number *Format: XXX-XXX-XXXX

Preferred Contact Method *Select all that apply.EmailPhone Call & VoicemailWhatsApp MessageText Message