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Disability Services

Online Request / Cancellation Form for
Interpreter or Transcriber

*Student's Full Name:

*Student's Phone:
(Ex. 828-438-5555)

 (*Please include area code)

*Student's Email Address:

I am requesting an (a):

 Interpreter  Transcriber Both

I am cancelling an (a):

 Interpreter  Transcriber Both

*Title of Event or Class:

*Building and Room number: 
(Ex. Carr Hall 240)

*Date of Event or Class:
(Ex. Oct. 3, 2011 or 10/3/2011)

*Beginning Time of Event or Class:
(Ex. 8:00 A.M. or 7:00 PM)

*Ending Time of Event or Class:
(Ex. 9:00 A.M. or 8:30 PM)

I understand that it is my responsibility to:

  • Notify Disability Services of class or schedule changes.

  • Notify Disability Services 24 hours in advance if I am unable to attend the event or will be absent from class.

  • Notify Disability Services if my assigned interpreter is unable to meet my language needs.

  • Request services at least 3 business days in advance.  Less notice may mean services are not available.

Sending this form indicates that you understand the above responsibilities.

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