College of DuPage American Sign Language Interpreter Advanced Certificate/Degree Program
Observation Form
(Submit to the Office of Admissions and Outreach, SSC 2207)
A minimum of 15 hours of American Sign Language observation must be documented.


The clinical experience must occur within the last five (5) years
A separate form must be submitted for each facility, experience or setting
To Be Completed By the Applicant
Applicant Name:
Name of Facility:
Address:
City:
State:
Zip Code:
Phone Number of Facility:
Date of observation:
Total Number of hours observed:
To Be Completed by the Facility
______________________________________
Signature of Witness at Facility
______________________________________
Printed Name of Witness
______________________________________
Date
______________________________________
Number of hours observed
American Sign Language Interpreter Advanced Certificate/Degree Program
Essay Requirement
Essay must be typed, consisting of at least 500 words, double spaced and no more than four pages long.
Essay is to be submitted to the College of DuPage Office of Admissions & Outreach, SSC 2207 or emailed to
hsadmissions@cod.edu. Please be sure to include your full name and student ID number.
Explain how you became involved in learning American Sign Language. What contribution can
you make to the Deaf Community as a result of completing the ASLI program? What will be
necessary of you, as a student, to ensure success in this program, and where does your motivation
come from to receive a certificate or degree?
American Sign Language Interpreter Advanced Certificate/Degree Program
Proficiency Exam Rubric
Student: _____________________
ID#:_____________________ Date: _________________
Expressive Exam
_____ Sign Production (25 points)
 Palm Orientation
 Space (appropriate location and position)
 Hand (comfortable; not stiff or rigid)
 Adequate Signing Speed
 Fingerspelling (Accurate, no letter mixed up, no letter(s) omitted, no hesitation)
 ASL Numbering Systems (Ordinal, Cardinal, Specific Numbering, smooth, clear)
 ASL Prosody (pausing, stressing, smooth)
 Clarity and Fluency
____
ASL Syntax (25 points)
Correct use of syntax
________ Yes/No Questions
_________ Rhetorical Questions
________ What Questions
_________ If or When
________ Negation
_________ Affirmation
________ Board Vocabulary
________ NMS Use of Non-manual Signals (lexical mouthing, adverbial marking, narrator
emotions/affect, body language/gestures
_____ Conceptual Accuracy (25 points)
 Main Concepts are Interpreted Clearly
 All Details Included
 No Deviation from Original Message
 Able to Repair Mistakes
 Ability to Distinguish Registers
______ Roleshifting & Classifiers (25 points)
 Clear Eye Contact
 Body Shift
 Use of Classifiers (Conceptually Accurate, appropriate movement/handshape)
 Use of Space (3D space)
 Mapping (Ability to set-up people, place, and objects in space)
Total: ____________\100
Receptive Exam
Students are required to view the ASLI Receptive Exam video and complete multiple-choice and fill-inthe-blank exam afterwards.
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Must have 70 + points to pass expressive exam and 70% to pass receptive exam.
Students are to contact the Program Coordinator to schedule an appointment for
testing.