M. E. SERVICES COMMUNICATION, INC.

INTERPRETING & TRANSLATIONS

P.O. BOX 30 577

Rochester, N.Y. 14603

Phone# 585-256-6519

Fax# 585-256-6215

APPLICATION

 For Freelance Interpreting Services

Personal Information:

Name: (First; middle; Last)

Social Security Number:  (call us with this payroll information)

Home Address:

City:

State:

Zip:

Home or Cell Phone:

Pager #:

Can you prove your U.S. Citizenship? Circle one:                            

Yes

No

If not a U.S. Citizen, give Visa No. and Expiration Date:

POSITION APPLYING FOR:

Education Record /fill out or attach Resume'

High School (Name, City, State):

Diploma:   Y / N

Business or Technical School (Name):                                                                                                     Degree Earned:  Y / N