SAS Class Interpreter Request

ASL Interpreter Request Form - Student Accommodation Services

(For Requesting American Sign Language (ASL) Interpreters for Classes)

Student Information

Full Name:

Student ID Number:

Student Email Address:

Student Phone Number:

Preferred Method of Contact:

Email:

Phone:

Academic Term

Choose One:

Fall

Spring

Summer

Other…

Year:

Class Schedule Requiring Interpretation

Please provide full details for each course needing an ASL interpreter (Course Title, Course Code, Course location, Days and Times (room/building) You may attach your official course schedule if preferred.

Upload Schedule:

One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Type of Interpretation Requested (select all that apply)

In-person ASL interpretation

Remote/Video remote interpreting

Captioning

Other…

Additional Information

Are there any specific interpreter preferences (gender, prior experience, etc.)

No

Yes

Have you worked with our office before?

No

Yes

Any other relevant information or requests?

Agreement

I understand that this request does not guarantee immediate fulfillment and that interpreter assignments are based on availability and course scheduling.

I agree to notify the Student Accommodation Services office promptly if there are changes to my schedule or if an interpreter is not present.

Signature:

Sign above

Today's Date: