Lee's Summit R7 School District Interpreter Request Form

This form is to be used to request a sign language interpreter for a school-related event. Please complete this form and click on the Submit button at the bottom of the form. All fields must be filled in completely. Partially completed forms will not be reviewed.
Upon successful submission, your request will be routed to the District Hearing Impaired Teachers for review.

NOTE: REQUESTS RECEIVED WITHIN 48 HOURS OF THE EVENT WILL NOT BE HONORED. ALSO, NO SPECIFIC INTERPRETERS MAY BE REQUESTED.

Requestor: Requestor: First Last
Phone: Phone: - ### - ### ####
Email:
Person requiring interpreter: Person requiring interpreter: First Last
Date of Event: Date of Event: / MM / DD YYYY
Name of Event:
Location of Event:
Time Event Begins: Time Event Begins: : HH MM AM/PM
Time Event Ends: Time Event Ends: : HH MM AM/PM
Type of Event:
Special Circumstances: