Freelance Linguist Data Sheet

TitleFirst NameLast NameCompany Name

Residential Address (Line 1)Residential Address (Line 2)Town/CityState/ProvincePostal/ZIP CodeCountry

Billing Address (Line 1)Billing Address (Line 2)Town/CityState/ProvincePostal/ZIP CodeCountry

Work PhoneMobile PhoneE-mailE-mail 2Skype IDWebsite

Country of OriginNative LanguageCitizenship 1) 2) 3)Years of in-Country Residence Current: Origin: Other:

Source Language Target Language Number of Years Notes

Services Provided: (Please mark all that apply)

TranslationInterpretation (Consecutive)

Back-translation

Interpretation (Simultaneous)Proofreading/Editing On-Site Document Review

Copywriting

Voiceover

Search Engine Optimization

Quality Checks (Final Eye)

Sworn TranslationCultural Consultancy

Desktop Publishing (DTP)Engineering

Testing

Project Management

Technical WritingTranscription Braille

Interpretation (Sign Language)

Interpretation (Court-certified)

Interpretation Equipment

Interpretation (Over-the-Phone)

Field Years Experience Field Years ExperienceCommunication Food & BeverageCorporate Communications General Food & BeverageJournalism / Publications MenuPress Release EducationPublishing ParentRetail TeacherApparel Life SciencesBeauty Batch RecordsConsumer Products Biochemistry - Drug CompositionDurables Clinical Reported OutcomeToys & Crafts Clinical Research ProtocolMarketing CRF (Case Review Form)Ad Copy CRO (Clinician Reported Outcome)General Marketing CTA (Clinical Trial Agreement)Hotel CV (Curriculum Vitae)Leisure Discharge SummaryPrint Advertising Doctor/Patient TranscriptSports & Fitness Drug LabelTourism e-LearningDurables Ethics Committee LetterFinancial Financial DisclosureAccounting General Life SciencesAnnual Reports Global CommunicationsBasic Banking Handwritten Patient NotesBenefits Information Health Questionnaire - Non ClinicalBusiness Cards Healthcare Mktng - ClinicalCompany Brochure Healthcare Mktng - Non ClinicalFinancial Fact Sheets IB (Investigator Brochure)Financial Instruments ICF (Informed Consent Form)General Investment IMPDHedging/Risk Management Indemnification LetterInvestment Analyses Investigator MeetingMarket Commentary Investigator/Site Binder DocsProspectus IVRSSecuritizations Lab Manual / FlowchartHuman Resources Letter of AuthorizationHandbooks & Manuals Local EC Submission DocumentsNewsletters MAA/eCTD/NDA (QRD Team only)Policy Manufacturer AuthorisationLearning & Development Normal Lab RangesBusiness & Soft Skills Patient / Medical ReportEducation (K-12) Patient BrochureEthics & Compliance Patient CardFinancial - SAP/Oracle Patient DiaryHealth & Safety Patient Information LeafletManagement / Development Patient Recruitment MaterialSales Training PM (Product Monograph)Technical Power of AttorneyInsurance PRO (Patient Reported Outcomes)Forms Product Characteristics SummaryPolicy Public Health InformationPatents Qualified Person CertificateAutomotive Patents RA Submission LetterChemical Patents SAPEngineering Patents Scientific Journals/ArticlesGeneral Patents Serious Adverse Events FormPharma/Medical Patents Site ContractSemiconductor Patents SOPsTechnical Patents TrainingTechnical MedicalAeronautics / Aerospace CardiologyAutomation Consumer DevicesAutomotive DentalConstruction Hospital EquipmentElectronics IFU/DFUEngineering - Mechanical Imaging/RadiologyEngineering - Chemical IVD (In Vitro Diagnosis)Engineering - Civil Medical DevicesEngineering - Electrical OrthopedicEngineering - General Stents, Grafts & CathetersEnvironmental Surgical InstrumentsTelecoms LegalIT - Doc & Help (UA) ContractsIT - ERP/CRM Court Papers

Expertise: Please indicate years of full-time experience in each field.

IT - Games Deposition NoticeIT - General Employee CorrespondenceIT - Graphics Software Federal CourtIT - Hardware FinancialIT - Marketing Government / NGOIT - Software (UI) InsuranceMachinery Lease AgreementManufacturing / Industrial Mergers & AcquisitionsMilitary / Weaponry Personal DocumentsMining State CourtMSDS Terms & ConditionsMultimedia Applications Other NuclearOil & GasUser Manuals

Regular Rates (in USD) CAT tools Rates (in USD)Per Word 100% MatchesPer Hour 75-99% Fuzzy MatchesPer Half-day Other Services Rates (in USD)Per Day

Which computer platform do you use?

Please answer all of the following: Response

Are you a full-time or part-time translator?

What is your daily output, in words?

Do you work with a proofreader or any outside reviewer?

BUSINESS CLASSIFICATION REPORTING:1. Country of Origin - Please select ONLY ONE of the following:

2. Size Standard - Please select ONLY ONE of the following:

If you answered "Small Business", please proceed to Question 33. Small Business Classification - Please select ALL that apply:

Software Packages: (Please mark all that apply)

List any additional software packages

When are you most able to handle new translation requests (mornings, evenings, weekends)?

How long you have been translating, and approximately how much volume (in approximate word count) have you handled?

What are your top two fields of expertise for translation material?

Do you have any academic experience or professional training/history relating to either of those fields?

Please list some of the specific types of texts that you have translated/proofread pertaining to these fields.

Please list any past clients that you have worked with. Or, if you prefer keeping this confidential, please list the fields that they are in (i.e., translation agency, pharmaceutical company, law firm, etc.).

If you answered "U.S.-Owned Business", please proceed to Question 2

Mac PC

MS Word SDLX

PowerPoint MS Excel

Adobe SuiteWordfast Classic

TradosWordfast Pro

U.S. Owned Business Non-U.S. Owned Business

Small Business Large Business

HUBZone Small Business

Women-Owned Small Business

Veteran-Owned Small Business Small Disadvantaged Business Service-Disabled Small Business

Please list all degrees obtained from any post-secondary institutions.Name of Institution Degree/Concentration Dates of Attendance

Please list relevant professional experience and include name of host institution and duration of service, where applicable.Name of Employer Job Title Duration of Service

Have you been granted any government security clearance?Details:

Please provide three professional (linguistic) references, at least one of which should be an end client:Name of Organization Name of Contact Contact E-mail Phone Number

THANK YOU!tpt 075 rev. 4 20140303

Note: At this time, there is no official certification process that determines a small business. Currently, the process is a self-certifying, paperless procedure. The United States Small Business Administration (SBA) uses the North American Industrial Classification System (NAICS) to determine sizing standards. To see if your business is considered small by the federal government, or to determine which NAICS Code(s) is applicable to your business, please visit:

http://www.sba.gov/contractingopportunities/officials/index.html

Please list any relevant certifications (i.e. Sworn, Court-certified, ATA, NAJIT, AIIC):

Yes No