Title *

Select Mr Ms Mrs Miss Dr Captain Rev

Firstname *

Surname *

Address *

Town/City *

County/State

Zip/Postcode *

Country*

Select Afghanistan Albania Algeria Angola Antarctica Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belarus Belgium Belize Bermuda Bolivia Bosnia Herzogovina Botswana Brazil Bulgaria Burundi Cambodia Cameroon Canada Cayman Islands Central African Rep. Chad Chile China Colombia Congo Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Dominica Dominican Republic Ecuador Egypt El Salvador Estonia Ethiopia Finland France Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Guatemala Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kuwait Latvia Lebanon Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malaysia Malta Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria North Korea Norway Oman Pakistan Palau Panama Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Samoa Saudi Arabia Senegal Sierra Leone Singapore Slovakia Slovenia Somalia South Africa South Korea Spain Sri Lanka Sudan Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Trinidad & Tobago Tunisia Turkey Turkmenistan Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Venezuela Vietnam Virgin Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe Other

e-mail Address*

Telephone Number (landline)*
include your country and city code
(if you don't have a landline, write 'NONE')

Telephone Number (mobile)*
include your country and city code
(if you don't have a mobile, write 'NONE')

Fax Number - include your country and city code

Nationality*

Mother Tongue*

Select Afrikaans Albanian Amharic Arabic Armenian Azerbaijani Bahasa Indonesia Basque Belarusian Bengali Berber Bosnian Bulgarian Cambodian Cantonese Catalan Chinese (Mandarin) Cornish Croatian Czech Danish Dutch English Estonian Farsi Finnish Flemish French Gaelic Galician Georgian German Greek Guarani Gujarati Hebrew Hindi Hungarian Icelandic Irish Gaelic Italian Japanese Kannada Kashmiri Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maltese Mongolian Nepali Norwegian Pashto Polish Portuguese Punjabi Quechua Romanian Romany Russian Sanskrit Serbian Sinhalese Slovakian Slovenian Somali Spanish Sudanese Swahili Swedish Tagalog Telegu Tamil Thai Tibetan Tshivenda Turkish Twi Ukrainian Urdu Uzbek Vietnamese Welsh Wolof Yiddish Yoruba Zulu

Mother Tongue 2
(if you are bilingual)

Select Afrikaans Albanian Amharic Arabic Armenian Azerbaijani Bahasa Indonesia Basque Belarusian Bengali Berber Bosnian Bulgarian Cambodian Cantonese Catalan Chinese (Mandarin) Cornish Croatian Czech Danish Dutch English Estonian Farsi Finnish Flemish French Gaelic Galician Georgian German Greek Guarani Gujarati Hebrew Hindi Hungarian Icelandic Irish Gaelic Italian Japanese Kannada Kashmiri Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maltese Mongolian Nepali Norwegian Pashto Polish Portuguese Punjabi Quechua Romanian Romany Russian Sanskrit Serbian Sinhalese Slovakian Slovenian Somali Spanish Sudanese Swahili Swedish Tagalog Telegu Tamil Thai Tibetan Tshivenda Turkish Twi Ukrainian Urdu Uzbek Vietnamese Welsh Wolof Yiddish Yoruba Zulu

Date of Birth*

Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month 01 02 03 04 05 06 07 08 09 10 11 12 Year 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Place of Birth (town or city)

Country of Birth *

Select Afghanistan Albania Algeria Angola Antarctica Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belarus Belgium Belize Bermuda Bolivia Bosnia Herzogovina Botswana Brazil Bulgaria Burundi Cambodia Cameroon Canada Cayman Islands Central African Rep. Chad Chile China Colombia Congo Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Dominica Dominican Republic Ecuador Egypt El Salvador Estonia Ethiopia Finland France Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Guatemala Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kuwait Latvia Lebanon Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malaysia Malta Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria North Korea Norway Oman Pakistan Palau Panama Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Samoa Saudi Arabia Senegal Sierra Leone Singapore Slovakia Slovenia Somalia South Africa South Korea Spain Sri Lanka Sudan Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Trinidad & Tobago Tunisia Turkey Turkmenistan Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Venezuela Vietnam Virgin Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe Other

..... Yes No .....

..... Yes No .....

Previous Employers/Other Agencies (please state company name, location, dates you  worked there, and position held, write NONE if you have never worked before)*

Qualifications (please include university level qualifications, language/translation and other non-language qualifications stating the institution,  qualification, dates and level achieved)*

References (please give us the names and contact details - address/email/phone of 1 or 2 references who are familiar with your translation work - you can do this later if you prefer)

Hobbies & Interests (this may be useful to match you with a translation subject of a similar nature)*

..... Yes No .....