Interpreter-Transcriber Request Form

Please note that you have successfully submitted your request when you receive an automatic response email.

Requester Information
Name of Requester*
First Last
Requester's UTK Email*
Enter Email Confirm Email
Requester's Best Contact Number*
Requester's Information*
Please select below
Name 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*
Name 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*

Event Information
Type of Event*
- Meeting
- Program
Date of Event*
MM slash DD slash YYYY
Start Time*

: Hours

Minutes

AM/PM
Expected End Time*

: Hours

Minutes

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 Schedule
If 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, Max. file size: 29 MB.
Name of Event Coordinator
If different from Requester.
Event Coordinator Phone Number
If different from Requester.
Event Coordinator Email (If known)
If different from Requester.
If this is an ongoing meeting/event, please select below
If applicable
- Weekly
- Bi-weekly
- Monthly
Will videos/media be shown at this Event?
Is the video/media Captioned or transcribed?*
Title/media Information
Preferred Interpreter or Transcriber (Optional)
Additional comments/information that may be helpful in providing interpreting/transcribing services
Phone
This field is for validation purposes and should be left unchanged.

Office of Equity & Diversity