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Contact Information

Disability Support Serivices
PO Box 1510
Pembroke, NC 28372

Phone/Voice: 910.521.6695
Fax:
910.521.6891
TTY: 910.521.6490
Email:
dss@uncp.edu

Location: D.F. Lowry Building, Room 103
Campus Map

 

 


UNCP INTERPRETER/TRANSLITERATOR REQUEST FORM

 

 

If you need an interpreter/transliterator for a UNCP sponsored activity, fill out the form below and return it to the Disability Support Services office two weeks in advance. You will then receive the bottom portion of this form back when an interpreter/transliterator has been scheduled for you.

 

 

Your Name

Today’s date

Email:

Phone/TTY number:

 

Sign preference (please circle one): ASL/PSE/MCE/CUED/TACTILE

 

 

Event/activity?

 

Location?

 

Date/s

Day/s

Starting time:

Ending time:

 

Additional Information

 

 

 

 

Signature________________________________________________

 

 

DO NOT WRITE BELOW THIS LINE

------------------------------------------------------------------------------------------------------------

 

OFFICE USE ONLY

 

Interpreter

Client:

Event/activity:

Dates & Times:

Location:

 

DSS Signature:

Special arrangements:

 

 

 

 

Updated: Thursday, June 19, 2008

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PO Box 1510 Pembroke, NC 28372-1510 • 910.521.6000