Center for Students with Disabilities - Interpreter Form | UW - Whitewater

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Interpreter Request Form

Request Information:

It is recommended requests are submitted 10 business days in advance. Requests submitted with less than 48 hours (2 business days) notice cannot be guaranteed.

To cancel a request, please email dhh_cancellation@uww.edu with a minimum of 48 hours notification.

I have read the above information.

Your Information: First Name: * Last Name: * Department/Student Organization/Event Sponsor: * Phone number: * Email: *

Student/Guest Information: Name of the Deaf Student/Guest: What type of interpreting or service is the Student/Guest requesting? *
(please check all that apply) American Sign Language Signed English PSE Voicing Oral Interpreters Real-Time Captioning FM systems

Event Information Event Start Date: * Event End Date: * Event Start Time:
: *
Event End Time: : *
Event Location and/or Building: * Event Room Number (Optional): Other Event Information (Parking, etc): Class/Meeting/Event Type: Class-related Meeting Job Interview Student services appointment (financial aid, admissions, or other department) Student Organization Campus Event (give details in the comment section) Other (give details in the comment section)

Comments, Questions, or Other Information:

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