Deaf/Hard of Hearing Faculty & Staff Interpreter Request Form

Please make sure you complete all the required fields (fields with an * next to them) before you submit the form. Once the form has been submitted correctly you should receive a confirmation email.

Deaf/Hard of Hearing Faculty & Staff Interpreter Request Form

Deaf/Hard of Hearing Faculty & Staff Interpreter Request Form
Deaf Consumer Name*
Deaf Consumer Email*
Deaf Consumer Text*
Type of Event (class, performance, meeting, etc.)*
Please provide detailed description of the event. Please include the nature of the event and any specialized vocabulary.*
Event Information
Is this a recorded or streamed event?*
Is this a recorded or streamed event? If so, will interpreters appear on screen?*
Date of event*
Month
Day
Year
Start Time

: Hours

Minutes

AM/PM
End Time

: Hours

Minutes

AM/PM
Event Location
Address*
Virtual meeting Link (WebEx, Zoom, etc.), if applicable
Building Name*
Room Number*
On-Site Information
Point of Contact or Meeting Host Name*
Point of Contact or Meeting Host Phone Number*
Point of Contact or Meeting Host Email Address*
Information for Interpreter
Is parking validation available for interpreter(s)?*
If yes to parking validation, please share the parking location and instructions.
If meals or refreshments are provided for participant(s), will meals be provided for interpreter(s)?*
Meals provided include (check all that apply)
- Refreshments
- Breakfast
- Lunch
- Dinner
Additional Information
Please provide any additional context and important information about the event here. Include relevant links or websites.
Upload any relevant pamphlets, brochures, or flyers about the event.
Max. file size: 50 MB.

Deaf/Hard of Hearing Faculty & Staff Interpreter Request Form

Event Information

Event Location

On-Site Information

Information for Interpreter

Additional Information