Department of Budget and Management

#18-009009-0033
Supplemental Questionnaire

Last Name
First Name

Please indicate your American Sign Language skill level:

a. Polite (able to greet and exchange pleasantries; indicate or understand an emergency)

b. Literate (understands a conversation and can respond)

c. Fluent (is your native language or can converse in the language as if it was your native language.)

d. Do not speak sign language.

Do you currently have any state or national certifications in ASL (ASL TA, RID, NAD, etc.)? If yes, please list them below. If no, write “N/A.”

Do you have experience as a classroom teacher or experience teaching ASL as a primary language (L1) teacher? If yes, please explain below.