Community Volunteer Interpreter Request Form

Points to note

You can make requests from this page until four days before the requested interpretation date; if the request is within four days, please contact us by phone. However, there may be times when an English-speaking staff member is unavailable to take your call.
We are unable to provide document translations or to fill in documents on your behalf.
Community interpreting volunteers are unable to provide advice or decisions regarding the matter being interpreted.
If you have email restrictions such as a spam filter, please make sure that you can receive email from sic-info.org.
Information that you provide is only used for the community volunteer interpreter dispatch. Information required for interpretation may be communicated to the dispatched volunteer.
* Information is required. Please fill in completely.

Applicant information

Applicant name*
Hiragana/Katakana
Affiliated group (name)
Postal code
Address
Telephone 1*
Telephone 2
E-mail*

Interpretation information

Name of person to be interpreted
Birth date	,
Sex
Nationality*
Language*	Japanese ⇔ English
Requested day for interpretation*	Please apply up to 4 days prior to interpretation. For requests within 4 days, please contact us by phone.
Requested time*	Maximum 3 hours for dispatch. Start time*: - End time:
Location (name)*
Location (address)
Content to be interpreted*	Topic/Field of interpretation* Please write information about the interpretation below. Using this information, the volunteer can plan and interpret in a smooth manner. If you do not know the content to be interpreted, or if you do not wish to share information, please write "unknown/do not wish to share." Detail* If interpreting through Skype is acceptable, please check below. Can use Skype Please write information about the interpretation below. Using this information, the volunteer can plan and interpret in a smooth manner. If you do not know the content to be interpreted, or if you do not wish to share information, please write "unknown/do not wish to share." Medical department* Name of illness Symptoms* Other information
Notes	Please write if you have anything you would like to tell the Shimane International Center (SIC) or volunteer interpreter.

Agreement

The SIC and the community volunteer interpreter shall bear no responsibility for the interpretation as conducted by the volunteer and any associated affairs therein.

I agree to the above and request the dispatch of a community volunteer interpreter.

Once we receive your request for a community volunteer interpreter, we will send you a request confirmation email.