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Interpreter Request Form

To request an interpreter via e-mail, please complete the form below and press the "Submit Request" button at the bottom of the page. You will receive a confirmation that your request has been received and notification of who your interpreter(s) will be. If you have any questions, please e-mail the Interpreting Services Coordinator,at DSInfo@colorado.edu or call (303) 492-8671 V/TTY.

PLEASE COMPLETE THE FORM AS FULLY AS POSSIBLE TO EXPEDITE YOUR REQUEST.

Requester name

Requester phone (include area code)   - -

Requester title

Requester e-mail

Deaf participant #1

  Participant is:

       Faculty
       Staff
       Student
       Other (specify in "Special Notes" box below)

  Participant is:

       ASL
       Signed English
       Oral
       Other (specify in "Special Notes" box below)

Deaf participant #2

  Check all that apply in this group:

       Faculty
       Staff
       Student
       Other (specify in "Special Notes" box below)

  Check all that apply in this group:

       ASL
       Signed English
       Oral
       Other (specify in "Special Notes" box below)

Day
       Sunday
       Monday
       Tuesday
       Wednesday
       Thursday
       Friday
       Saturday

Date

Time: from   to

Type of Event (meeting, conference, lecture, etc.)

Event Location

Special Notes (agenda, meeting outline, guest speakers, etc.)

Contact person

Contact phone (include area code) - -

Contact title

PAYMENT
The sponsor of the event/activity is responsible for payment of non-curricular interpreting services. Please complete the information below as thoroughly as possible.

Speed type
PeopleSoft account # (such as 552605)

Account contact

E-mail address

Phone number - -

Department

Campus box number

NOTE: The cost for interpreting services will be charged to the Speed Type and PeopleSoft number indicated on this form. Please verify that all information is current. A copy of the transaction will be mailed to the account contact person for account reconciliation.