TransXpert Inc.

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Application Form

* - Required fields

Contact Information:

* Company Name U.S. based Freelancer(W9) Non-U.S. Freelancer (W8)

Title:

* First Name:

* Last Name:

* Address:

* City:

State:

Specify Other:

*Zip/Postal Code:

* Country:

* Phone 1:

Cntry City # x

Phone 2:

City # x

* Fax 1:

Cntry City #

Fax 2:

Cntry City #

* Email Address:

Website Address:

http://

Accreditation:

Yes No

If Yes, Association Name?

* SSN:

Native Language:
Years Experience:

Notes:

* Education:

Experience:

Services and Rates:

Services	Rate
Translation	Source: Target: Technical: $ /word, Non-Technical: $ /word, Volume: $ ---- Source Target: Technical: $ /word, Non-Technical: $ /word, Volume: $ ---- Source Target: Technical: $ /word, Non-Technical: $ /word, Volume: $ ---- Source Target: Technical: $ /word, Non-Technical: $ /word, Volume: $ ---- Source Target: Technical: $ /word, Non-Technical: $ /word, Volume: $ ---- Source Target: Technical: $ /word, Non-Technical: $ /word, Volume: $ ---- Source Target: Technical: $ /word, Non-Technical: $ /word, Volume: $ ---- Source Target: Technical: $ /word, Non-Technical: $ /word, Volume: $ More Languages... Comments:
Editing	Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ More... Comments:
Proof Reading	Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ More... Comments:
DTP	Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ More... Comments:
Voice Over	Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ More... Comments:
Interpreting	Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ More... Comments:
Voice Transcription	Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ ---- Source: Target: @: $ / , Min. Amt. : $ More... Comments:
Closed Captioning	Comments: @ $ / , Min. Amt. : $
Sub-titling	Comments: @ $ / , Min. Amt. : $
Studio	Comments: @ $ / , Min. Amt. : $
Equipment	Comments: @ $ / , Min. Amt. : $ ---- Comments: @ $ / , Min. Amt. : $ ---- Comments: @ $ / , Min. Amt. : $ ---- Comments: @ $ / , Min. Amt. : $ More...
Other	Comments: @ $ / , Min. Amt. : $

Fields of Expertise:

References: (3 minimum) Required only if free-lancer

1.	Name:	First: Last:
	Company:
	Email:
	Phone:
	Mailing Address:
	Notes:

2.	Name:	First: Last:
	Company:
	Email:
	Phone:
	Mailing Address:
	Notes:

3.	Name:	First: Last:
	Company:
	Email:
	Phone:
	Mailing Address:
	Notes:

4.	Name:	First: Last:
	Company:
	Email:
	Phone:
	Mailing Address:
	Notes:

5.	Name:	First: Last:
	Company:
	Email:
	Phone:
	Mailing Address:
	Notes: