Live Audio Description Request Form

"*" indicates required fields

Requester Name *

Requester Email *

Event Name *

What department is hosting the event(s)? *

Brief Event Description *

Event Date *

Event Start Time *

Event End Time *

Address *

Address and/or the event's Zoom link.

Suite # *

Please include the event's room number and/or the Zoom meeting ID.

On-Site Contact Name(s) *

On-Site Contact Phone Number(s) *

Is this requested service for a student or employee attendee with accommodations? *

This is an accommodation for a student

This is an accommodation for an employee

This is an open access request

Name of the Student or Employee *

First Last

C-FOAP *

A C-FOAP number is required for processing this request. If you do not have a C-FOAP number, please consult your department admin.

Additional Information: