Interpreter request forms and appropriate documentation must be submitted to the SSWD office a minimum of 2 weeks before services are needed. Students are required to notify SSWD immediately if there are schedule changes. Cancellations must be received 24 hours in advance. After two no-shows or last-minute cancellations students are required to meet with the SSWD director to re-request interpreter services. Please consult your SSWD Student Responsibilities packet for further explanation.
Student Name _____________________ Student ID/SSN ______________
Phone/TTY _________________ Email _________________@____________
Today's Date ________________ Current Time ______________
Indicate the intended purpose for an interpreter role:
___ Admissions/Advising
___ Placement Testing
___ Financial Aid
___ New Student Orientation
___ College Classes
___ Student counseling
___ Instructor/student meeting
___ TRiO
___ Student study group
___ Final Exam
___ Field Trip
___ Workshop
___ Other (please specify) ________________________________________
Appointment Day(s) ____________________ Date(s) ____________________
Time: Beginning ________ Ending ________
Exact location (e.g. site, building, classroom, area venue):
__________________________________________________________________________
Return completed form to:
Michele DeFelice, Coordinator/Lead Interpreter
PSTCC, J.L. Goins Adm. Bldg, Room 131-D
10915 Hardin Valley Rd.,P.O. Box 22990
Knoxville, TN 37933-0990