Interpreter-Transcriber Request Form Please note that you have successfully submitted your request when you receive an automatic response email from Disability Services. If you have not received an email, please contact ODS immediately. Feel free to contact ODS for associated fees. Step 1 of 2 50% Requester InformationName of Requester* First Last Requester's UTK Email* Enter Email Confirm Email Requester's Best Contact Number*Requester's Information*Please select belowSelectStudentFaculty/StaffClub/Student OrganizationOffice/DepartmentName of Student Organization*Advisor's Information*Please enter the Student Organization's Advisor information First Last Advisor's Email Address* Advisor's Phone Number*Type of Request*SelectSign Language InterpreterTranscriberName of Individual who is Deaf or Hard of hearing*Contact Information for Individual who is Deaf or Hard of hearing (If known)Status of Individual who is Deaf or Hard of Hearing*SelectStudentFaculty/StaffParentUniversity GuestGeneral Audience Event InformationType of Event*MeetingProgramDate of Event* Start Time* : HH MM AM PM Expected End Time* : HH MM AM PM Location of Event*Description of Event*Name of Department (if applicable)Department Account Number for Billing Purposes*Please review the guidelines for providing interpreting/transcribing services and associated fees. Program Agenda or ScheduleIf a program or agenda is available, please use the link below to upload a copy. Accepted file types: jpeg, png, pdf, rtf, doc, docx, ppt, pptx, xls, xlsx, zip.Name of Event CoordinatorIf different from Requester.Event Coordinator Phone NumberIf different from Requester.Event Coordinator Email (If known)If different from Requester. If this is an ongoing meeting/event, please select belowIf applicableWeeklyBi-weeklyMonthlyWill videos/media be shown at this Event?SelectYesNoIs the video/media Captioned or transcribed?*SelectYesNoTitle/media InformationPreferred Interpreter or Transcriber (Optional)Additional comments/information that may be helpful in providing interpreting/transcribing servicesPhoneThis field is for validation purposes and should be left unchanged.