Page 1 of 7 ASL-English Interpretation Program City University of New York - LaGuardia Community College Pre-Screening Application for Fall 2017 (Deadline: Postmark or Hand delivery to AEIP Offices Friday, May 19, 2017) 1. Full name: (Last) (First) (Middle) 2. Permanent Address: (Street), (City) (State) (Zip Code) 3. Phone: Home ()_ Cell () Work () ext. Fax () 4. Email address: 5. Aside from ASL and English, please list any other spoken or signed languages in which you are fluent: _ 6. Educational History: A. I have completed (mark all that apply): HS Diploma AA/AAS BA/BS MA/MS Other B. List all post-secondary schools attended: Anticipated Date Dates of/or Degree Awarded, College Attended Major/Minor or # of Credits _
Page 2 of 7 C. Deaf Studies, ASL, and/or Interpreter Education: List academic programs, individual courses, workshops, etc. attended. Include all activities that you will complete prior to entrance into the program in September. School/Agency & Location Course Titles Dates Certificate, Credits, or Grade School/Agency & Location Course Titles Dates Certificate, Credits, or Grade *continue additional records on accompanying pages 7. Extra-curricular Activities: Please list extracurricular activities in the community or your college, which would show involvement related to the Deaf Community. Use more than one line for each, if necessary. Include volunteer experience. Activity/Duty Venue Location (city,state) Dates Involved _ Activity/Duty Venue Location (city,state) Dates Involved _ *continue additional records on accompanying pages 8. Employment History: Going back five years, please list all work experience. Be sure to include work related to the Deaf Community, if applicable. Include part-time work. Job Details: Job Details: *continue additional records on accompanying pages
Page 3 of 7 ADDITIONAL MATERIALS REQUIRED 1. Official college transcript from the highest degree attained. 2. Letters/Videos of Recommendation: Please include 2 letters of recommendation (written English or videotaped ASL). A) One letter must be a recommendation from a member of the Deaf Community. B) One letter must be a recommendation from an individual who can provide an Academic or Professional reference. To the Recommenders: Possible topics to include in your letter: the candidate s self-reflection abilities, interpersonal & communication skills, comfort in bicultural or multicultural interactions, involvement in the Deaf Community, level of ASL & English fluency, and academic/professional qualities, level of maturity, if applicable. 3. Application Video: Please prepare one of the following: DVD or CD: Acceptable formats for the submission include.mov for QuickTime,.wmv for Windows Media Player,.dv for DV Movie/iDVD, or MPEG-4. DVD or CD must be labeled with your full name. OR Video sharing website link (i.e. YouTube, Vimeo): Links should be emailed to aeip@lagcc.cuny.edu with your full name in the subject of the email. In terms of privacy settings, the pda.aeip@gmail.com email address should be given full viewing rights to all videos to ensure access. Whichever video format you choose, include all of the following: A) American Sign Language Section Part I - This portion of the video should be 3-5 minutes in length. Using American Sign Language only (without voice) describe: how you first became interested in sign language. your involvement in the Deaf community/first-hand experience with Deaf Culture. B) American Sign Language Section Part II - This portion of the video should be 2-3 minutes in length. Using grammatically acceptable ASL (including ASL sign order and structure, ASL Use of Space, appropriate nonmanual facial grammar, accurate size and shape classifiers), retell the story in this video (without voice). https://www.youtube.com/watch?v=umu90lbg2ku C) Spoken English Section This portion of the video should be 3-5 minutes in length. Using spoken English only (without sign) describe: your reasons for wanting to become a professional interpreter. your professional goals following completion of the Program. *CD/DVDs will not be returned unless the applicant has included a self-addressed and stamped appropriate mailer along with their Pre-Screening Application materials.
Page 4 of 7 4. Application Essay: Please prepare and attach to this application a 1 to 2 page typed essay answering the following question. Please support your ideas. What is your vision of an ideal ASL-English interpreter? What kind of qualities (linguistic, interpersonal, political awareness, etc.) do you feel are important and why? 5. $50 application fee. This must be money order or check. No cash will be accepted. Checks can be made out to LaGuardia Community College. How did you hear about this program? Please circle. Open House Panel Recruitment Event Program Website E-mail Announcement Word of Mouth Other: Completed application form Official college transcript 2 letters of recommendation Video (3 sections) Essay $50 application fee Final Checklist Send your application materials to: ASL-English Interpretation Program LaGuardia Community College 31-10 Thomson Avenue, Room C-203 Long Island City, NY 11101 Best of Luck!
Page 5 of 7 C. Deaf Studies, ASL, and/or Interpreter Education: List academic programs, individual courses, workshops, etc. attended. Include all activities that you will complete prior to entrance into the program in September. School/Agency & Location Course Titles Dates Certificate, Credits, or Grade School/Agency & Location Course Titles Dates Certificate, Credits, or Grade School/Agency & Location Course Titles Dates Certificate, Credits, or Grade School/Agency & Location Course Titles Dates Certificate, Credits, or Grade School/Agency & Location Course Titles Dates Certificate, Credits, or Grade
Page 6 of 7 8. Extra-curricular Activities: Please list extracurricular activities in the community or your college, which would show involvement related to the Deaf Community. Use more than one line for each, if necessary. Include volunteer experience. Activity/Duty Venue Location (city,state) Dates Involved _ Activity/Duty Venue Location (city,state) Dates Involved _ Activity/Duty Venue Location (city,state) Dates Involved _ Activity/Duty Venue Location (city,state) Dates Involved _ Activity/Duty Venue Location (city,state) Dates Involved _
Page 7 of 7 9. Employment History: Going back five years, please list only work experience related to the Deaf Community. Include part-time work. Job Details: Job Details: Job Details: Job Details: Job Details: Job Details: