#NAD2018 SSP Application

#NAD2018 SSP Application
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Text Number *

Area Code Phone Number
Gender *
Video Sample Instructions

Please record a video introducing yourself, include any experience and training in providing SSP or interpreting services. Explain your involvement with the Deafblind community and why you are interested in working as an SSP. Video minimum length is 3 minutes. Upload your video to YouTube and set to unlisted.
Video Sample unlisted YouTube link *
Resume *

Browse Files

Cancel of
Headshot *

Browse Files
Used for coordinating team and DeafBlind consumers to identify you. Cancel of
Certifications

Browse Files
Attach any/all proof of certification. Cancel of
Are you available to work the entire week, July 3-7? *
What dates are you available to work? *
In addition to providing SSP services, are you willing to do Mirror Interpreting in small workshops? *

Yes No
How much experience do you have in providing SSP services? *
How much experience do you have in Mirror Interpreting? *
How much experience do you have in using ProTactile ASL? *
When matching interpreters with DeafBlind people, the information below ensures that the best match is made.
Status *
Which is your dominant hand for signing? *
Can you sign with your non-dominant hand? *
Your height *
Smoking *

I am a smoker I do not smoke I can be matched with a smoker Please do not match me with a smoker
Do you plan to travel with a DeafBlind person? *
Name of the DeafBlind person you're traveling with *

First Name Last Name
Do you want to be matched with that person at the conference? *
Are you comfortable around guide dogs? *
How physically active are you? *
Do you have any physical limitations? *
What are your physical limitations? *
Should be Empty: