DMC Request for Interpreting Services Requests Date Requested:* MM slash DD slash YYYY Staff Name:* Location (If VRI, use DMC’s main address) Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code What kind of job it will be?* Face to face VRI (via Interpreter Intelligence) VRI (via another platform such as Zoom) Please only choose Interpreter Intelligence if DMC Zoom accounts are booked. The Interpreter Intelligence platform has a per minute rate and should only be used in rare circumstances. Language:* ASL ASL/Spanish DeafBlind- tactile Deaf Interpreter Consumer(s) Name (Deaf individuals):*Appointment Type (Reason for the request):*Date of Interpreting Job:* MM slash DD slash YYYY Start Time:*Hours:MinutesStart Time: AM/PM* AM PM End Time:*Hours:MinutesEnd Time: AM/PM* AM PM Job Details (If VRI, include Zoom meeting link):Select your manager to approve request:*Brittany ZazuetaDiane DunnJose PenaLarry WangerMegan GranataSocorro Merchain
