Frederick County Public Schools Interpreter Request or Cancellation

Your Name *

First

Last

Email *

Date of Request and Start Time *

Date

Time

End Time *

Would You Like to Enter Multiple dates/times for the same service recipient and location?

Yes
No

Please list all dates or range of dates including start and end times.

Will this be through Google Meet or In-Person? *

Google Meet
In-Person

Request Location

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who is Receiving Interpreting Services?

Student
Staff/Faculty
Parent/Family Member
Open Access/General Audience

Student's Name *

Grade Level *

Are there any Special Language Needs (deaf blind, cognitive impairment, behavioral concerns, or other important information)?

If You Have a Copy to the Student's Daily Schedule, Please Upload it Here

Click or drag a file to this area to upload.

Name of Employee Receiving Interpreting Services *

What type of Interpreting Will be Required? *

Please Describe Special Event (Field Trip, Back to School Night, Commencement, etc)?

Please Describe Event(s) to be interpreted *

Would You Like to Upload the Employee's Schedule? *

Yes
No

File Upload

Click or drag a file to this area to upload.

Please Describe the Class or Classes including grade levels *

Please describe the meeting including subject matter, estimated number of attendees, and if the service recipient will be utilizing the interpreter for any presentations *

Please describe the meeting including approximate number of attendees, student's grade level, and any relevant information to help the interpreter prepare *

Name of Parent(s) Receiving Service *

What is the Nature of the Event Requiring Interpretation? *

Teacher(s) Name(s) *

Student's Name *

Approximate Number of People Attending IEP Meeting *

Will an Attorney be Present? *

Yes
No
Unknown

Grade Level of Student and any Relevant Information to Help Interpreter Prepare *

Please Describe *

Would you like to add the Google codes now? (Not necessary if you are uploading a schedule with codes) *

Yes
No

Please enter the Google codes here. If there are multiple sessions, please be clear corresponding codes with sessions *