This form sends an e-mail to Deaf Services at Holyoke Community College.
The Deaf Services area of the Office for Students with Disabilities will make every effort to provide accommodations for all requested classes and/or activities. Please submit a completed Request Form to our office (Donahue 135) at least two (2) weeks in advance of the class or event that you would like accommodated to better ensure that an interpreter or C-Print captionist can be located. A failure to do so might limit our ability to meet your needs. (If you need accommodations at the last minute, you can let us know and we will make every effort to provide, but we cannot guarantee that we can.)
Today's Date:
Your Name:
If you are making request for someone else, who is the Deaf comsumer
Phone:
Voice
TTY
Both
Email:
Do you want an interpreter or a C-Print captionist?:
Interpreter
Captionist
Information about when the provider is needed -
Dates:
Dates2:
Times:
to
Type of situation (class(lecture or lab?), meeting, presentation, exam, etc.)
Name of instructor, presenter and/or person(s) in charge of the event:
Total number of activity participants:
Place (building and room number):
Interpreting needs:
Oral
ASL
PSE
Deaf/Blind
N/A
Name(s) of Provider(s) you would prefer:
(Note: we may not always be able to arrange for specific interpreters/captionists)
Other Comments: