Request for Interpreting/Real Time Captioning

Interpreting/Real Time Captioning Request

Name:

Email:

Student ID #:

Phone #:

School Year

Semester:

Accommodation Requested:

Dept. and Course #:

Call #:

If Part-term, start & end date:

Day of Class:

Start & stop time of class:

Building & Room #:

Instructor:

IMPORTANT: If you do not receive an email confirmation from Disability Services within 24 hours from the time this request was submitted, please contact Bunnie Johnson Messelt at bunnie.johnson-messelt@ndsu.edu or 701-231-7198.

This form is provided on our website for students' convenience. If you have concerns about the security and sensitivity of the information being shared, we recommend submitting a paper copy by requesting it from the Disability Services office to ensure a secure submission as we cannot guarantee confidentiality with online submissions. This form can be requested by calling Disability Services (701 231-8463) through ND Relay at 1 800 366-6888, or submitting an email to: ndsu.disability.services@ndsu.edu

North Dakota State University

Disability Services

Interpreting/Real Time Captioning Request

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