DPS Forms/Interpreter Request

The following form is to assist DPS in providing sign language interpreters for individuals who need access to courses, meetings, events or activities through Chaffey College.

Requests must be made at least 2 business days prior to the event. Requests submitted with less than 2 days’ notice may not be able to be granted.
**Exceptions for class time interpreters**

If you need to cancel the interpreter after a request is made, you must notify DPS via email or phone call within 48 hours in advance of the event.

All fields are required.

Please don't fill out this input box.

Student Name:*

Student ID Number:*

Phone Number:

E-Mail:*

Today’s Date:*

Type of Event (i.e., tutoring, meeting, etc.):*

Date of Event:*

Start Time:*

End Time*

Will video captioning be needed?*

Yes

Location*

Chino Campus

Fontana Campus

Rancho Cucamonga Campus

Building / Room Number:*

Where should the interpreter meet you? (If different from event location)*

** Request for class time interpreters should be made at time of registration so that a long-term interpreter can be contracted. Please email you class schedule at jessica.arreguin@chaffey.edu.

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