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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

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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

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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:

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SAS Class Interpreter Request

ASL Interpreter Request Form - Student Accommodation Services

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