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Interpreter Request

Interpreter Request



STUDENT AGREEMENT FORM FOR USING INTERPRETATION SERVICES

Policies and procedures for students scheduling and receiving interpreting / captioning service:
  • Please notify the Assistive Technology and Deaf and Hard of Hearing Coordinator (AT and DHH Coordinator) 2 full business days in advance, if you will not be attending a class whenever possible.
  • If you are absent 3 times without notification (No Show), interpreting / captioning services will be cancelled until you talk to our AT and DHH Coordinator to reinstate.
  • Please notify AT and DHH Coordinator whenever you are going to be late for a class so we can contact your service provider.
  • If you are 20 minutes late the service provider is free to leave, unless you notify us ahead of time.
  • If the class has started and there is no service provider, wait 20 minutes before contacting the AT and DHH Coordinator.
  • You must notify the AT and DHH Coordinator of any changes to your schedule. If you stop attending class or drop a course and do not notify us, it may result in suspension of services until you talk with the AT and DHH Coordinator to confirm your schedule and needs.
  • If you are having difficulty with a service provider, speak to the person to try and resolve the difficulty. If the problems continue contact the AT and DHH Coordinator for assistance.
  • A request form must be submitted each time that I need to have a service provider for special assignments. (Other than my service provider scheduled for my regular classes.)
  • Any college course related activity that you will need a service provider, you must submit a request at least 5 business days in advance.

Please feel free to contact me if you have any questions or concerns regarding these policies.
Thank You,

Jessica Alarcon
Assistive Technology and Deaf and Hard of Hearing Coordinator
Building 5400-Office 5418
E-mail: alarconjessica@fhda.edu
Phone: 650-949-7039

 
This question requires a valid date format of MM/DD/YYYY.
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6. One-Time Assignment? *This question is required.
7. Purpose of Request *This question is required.
8. Service Information *This question is required.
Days of Week *This question is required.
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9. Additional Class #2? *This question is required.
10. Class #2 *This question is required.
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10.  Additional Class #3? *This question is required.
11. Class #3 *This question is required.
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11. Additional Class #4 *This question is required.
12. Class #4 *This question is required.
Days of Week *This question is required.
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By submitting this form, I acknowledge that I have read and understood the guidelines. I understand any changes to the request must be notified to the DRC office as indicated within the guidelines. I understand that the lack of information provided in this form may result no action until all information is filled out.
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