Deaf/Hard of Hearing Faculty & Staff Accommodation Request Form

This form is for Mason faculty and staff members to request ASL interpreting services. If you are a visiting community member who needs ASL interpreting services, please reach out to apuopolo@gmu.edu. If you are a Mason department, please visit our Deaf/Hard of Hearing Services Requests Forms page to access the form to Interpreting Services Request Form.

Deaf Consumer Name(Required)

Deaf Consumer Email(Required)

Deaf Consumer Text(Required)

Type of Event (class, performance, meeting, etc.)(Required)

Is this a recorded or streamed event?(Required)

If event is recorded or streamed, will interpreters appear on screen?

Event Information

Date of Event(Required)

Start Time of Event(Required)

End Time of Event(Required)

Location(Required)

Campus Building and Room Number if on Mason Campus

Street Address

Address if not on Mason Campus

Street Address City ZIP / Postal Code

Virtual meeting link (WebEx, Zoom, etc.) if applicable

On-Site Information

Point of Contact Name(Required)

First Last

Point of Contact Phone Number(Required)

Point of Contact Email(Required)

Information for Interpreter

Is parking validation available for interpreters?(Required)

If yes to parking validation, please share the parking location.

If meals or refreshments are provided for participant(s), will meals or refreshments be provided for interpreters?(Required)

Additional Information

Please provide any additional and important information about the event here. Include relevant links or websites.

Upload any relevant pamphlets, brochures, or flyers about the event.

Drop files here or

Max. file size: 50 MB.

Deaf/Hard of Hearing Faculty & Staff Accommodation Request Form