The Minnesota Language Connection

(651) 644-7100

Bridging the Gap (BTG) Medical Interpreter Training - 40 hours

1) Complete the application in full. Incomplete applications cannot be accepted.
2) Payment must be made before the start of class, or we cannot issue a certificate of completion.
3) We will evaluate your application, and then contact you. Once accepted, you will be required to pay the full fee.

APPLICATION FORM

Name

First Name
Last Name

Contact Info

Home Address
Telephone
Email

Languages known best in order of written knowledge :

(list English as one of the languages and do not list more than three)

Language 1
Language 2
Language 3

Have you received any kind of interpreter training in the past?

Please rate the following about your language skills:

1 = Poor 2 = Fair 3 = Good 4 = Very Good 5 = Excellent

	1	2	3	3	5
Written knowledge of target language (Spanish, Arabic etc.)
Written knowledge of source language (English)
Spoken knowledge of target language (Spanish, Arabic etc.)
Spoken knowledge of source language (English)

Educational background:

Complete data from elementary school to college/university.

Years (From - To)
Language of Instruction
City, Country
Name of certificate, diploma, or degree obtained

Work Experience in Translation/Interpretation

Years (From - To)
Company
City, Country
Description

Please include a statement about why you want to take the Bridging the Gap training course.

Please write your statement first in English, and then in the language you will be interpreting (target language). You may cut and paste your statement here if preferred:

English:
Target Language:

I attest that all the information contained here is true and correct and upon request I shall provide necessary proof.

Date

Select date

Signature

Print your name

The Minnesota Language Connection (651) 644-7100