Accommodation Request
Parents in need of interpreter services are asked to complete this form:
TO:
Director of Pupil Services
Shaker High School
445 Watervliet Shaker Road
Latham, New York 12110
FROM:
________________________________________________________________
Name
________________________________________________________________
________________________________________________________________
Address
Please identify the type of interpreter needed and the date, time and location:
Interpreter for the Hearing Impaired: ( ) American Sign ( ) English
Date: ____________
Time: ____________
Location: ____________________________________________
In the event an interpreter is not available, please identify the type of alternative service preferred:
| ____ Written Communication | ____ Transcripts | ____ Other (please specify) |
Please return to the above address.
Requests for interpreters must be received by the District at least 3 days prior to the scheduled meeting or activity.
Date of request ____________ Date request was received ____________
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