City of Detroit ASL Request Form

REQUESTOR INFORMATION

Who is submitting the request?

Constituent / Resident

City of Detroit Employee

City Council Staff

Requestor's Name

Requestor Pronoun

She/Her

He/Him

They/Them

Other

Requestor's Phone Number

Requestor's Email

INTERPRETING SERVICE DETAILS

What is the name of the event or proceeding for which you are requesting ASL interpretive services?

On what date will ASL interpretive services be needed?

Please note that the Office of Disability Affairs needs at least 7 business days notice to properly process an ASL request. We may be able to process urgent requests in a shorter amount of time, but there is no guarantee.

mm/dd/yyyy

At what time will the proceeding or event begin?

Please use the format 00:00 AM/PM.

At what time will the proceeding or event end?

Please use the format 00:00 AM/PM.

Please select the type of proceeding or event for which ASL services are being requested.

Applications for City Services

General presentations and/or community workshops

Employment (Interviews / Staff Meeting / Training / Grievances / Discipline)

Meetings

News Reporting, Press Conference, Video / Audio Recordings

Political / Election events

Social and recreational activities

Please select the location for provision of ASL interpretive services.

In-person (within City of Detroit)

Remotely via video platform

Will this event be recorded and/or broadcasted?

Yes

If available, any interpreter preferences:

Please provide any additional information relevant to the ASL request below.

Meeting Documents

Please attach a copy of an agenda, PowerPoint slides, and/or handouts to allow for effective communication at the proceeding or meeting.

Drop your files here

Send me a copy of my responses

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