subject_line
Interpreter/CART Request for Event
Request Type
Select all that apply
Request Type
*
Live Captioning
Sign Language Interpreter
CART
Contact Information
Are you
*
Faculty/Staff
Student
Non Northeastern affiliated
First Name
*
Last Name
*
NU ID
*
Email Address
*
Phone #
*
Phone Type
*
Voice
Text
TTY
Video Phone
University Department
Student Group
Name of Onsite Contact
(if different from above)
Email Address of Onsite Contact
(if different from above)
Phone No. of Onsite Contact
(if different from above)
Payment Information
Budget number
*
Communication Preferences
Select all that apply
Communication Preferences
*
American Sign Language
Signed English
Oral
Deafblind
Unsure
Event Information
Date of Event
*
+
Name of event
*
Start time (mm:hh)
*
AM/PM
*
AM
PM
End time (mm:hh)
*
AM/PM
*
AM
PM
Location
*
Name of person giving the presentation
*
Audience
Select all that apply
Audience
*
Confirmed deaf/hard of hearing attendee(s)
General audience
Name of attendees
*
Type of Event
Select all that apply
Type of event
*
Group Meeting
Lecture
One on One meeting
Workshop/Conference
Other
Other
Materials
Please indicate any materials you will be able to provide us prior to the event.
Materials
*
A script or information packet
A flyer or advertisement
Other
Other
Please attach materials (if you have multiple files please zip them)
Note: If you cannot attach your materials, please send them to the Disability Resource Center in 20 Dodge Hall via interoffice mail. Please indicate the Reference # of this request.
Interpreter Information
Preferred Interpreters
Non-Preferred Interpreters
CART Provider
Preferred CART Provider
Non-Preferred CART Provider
Cancellation Policy
Cancellations made less than 2 business days in advance of event will be billed at full charge.
Please be sure to advertise that your event will be interpreted. If you have any questions contact the Disability Resource Center at x2675 (x2730 TTY).
Disability Access Services
360 Huntington Ave
20 Dodge Hall
Boston, MA 02115
Phone: 617-373-2675
Fax:617-373-7800
www.northeastern.edu/drc