If you would like to request this form in an alternative format please contact Disability Support
Services at 301-934-7614 or via email at ADA@csmd.edu
PROCEDURE FOR REQUESTING INTERPRETERS
Individuals who are requesting interpreter services MUST comply with the following
procedure:
1.
Student must complete an intake with the ADA Coordinator or Disability
Support Coordinator at the campus you will be attending or the campus closest
to your home.
2.
Request for an interpreter should be made by completing the correct paper
work, including this form and the Student Request for Interpreter Form no later
than six weeks before the beginning of the semester for which they are
requesting interpreters.
3.
To schedule an appointment, please email mrabie@csmd.edu (Leonardtown
Campus); rzgorski@csmd.edu (Prince Frederick Campus);
glennisd@csmd.edu (La Plata Campus) or relay call to 301-934-7614.
4.
For students requesting services for Drivers Education, it is important that you
specify the location.
5.
Request must be accompanied by the list of classes to be covered, the location,
and faculty's or instructor's name.
6.
Students who add a class must fill out a new request form. Students who drop
classes must notify the ADA Coordinator or the Disability Support Coordinator.
7.
Students requiring additional interpreter services for special projects and extra
credit assignments must request services at least seven working days in
advance.
8.
Due
to issues concerning liability, interpreters are not permitted to provide
services in students' homes.
9.
The College of Southern Maryland is not financially or otherwise responsible for
any student who enters into a contract with an interpreter without following
the college's written procedure for requesting interpreter services.
10.
If in the event a student is dissatisfied with the skill level, adequacy or
competence of the interpreter, the student must contact the ADA Coordinator
to appropriately address this issue.
11.
Students must inform the Disability Services Office of any class absences or
cancelations as soon as possible to ensure proper notification of interpreters.
If you would like to request this form in an alternative format please contact Disability Support
Services at 301-934-7614 or via email at ADA@csmd.edu
Role of the Interpreter
The interpreter's sole function is to provide equal access by interpreting information that
requires auditory processing for hearing-impaired or deaf students. The interpreter is
neither a tutor nor an assistant to the faculty or instructor.
Name: ____________________________________________________________
Date Requested:
Email: ____________________________________________
Street Address:
____________________________________________________
City: ______________ County: _________ State: _____ Zip Code: ________
Campus:
La Plata Prince Frederick Leonardtown Waldorf Hughesville
Other: ________________
Preferred
signing method: ASL _ PSE _ Voicing _ Signed English _ Other: _ ________
Course
Number
Instructor
Building/Room #
Start/End
date
Days and
Time
__________________________________________
___________________
Signature of Student:
Date:
__________________________________________ ___________________
Parent/Guardian Signature if student is under 18: Date:
Description of Assignment (Please be Specific):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Address of Assignment if Not College of Southern Maryland:
________________________________________________________________________________
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