DHH Captionist Request

Student Accessibility Services
9388 Lightwave Ave, San Diego, CA 92123
858.521.3968 (phone) ● 858.521.3996 (fax) ● DHHSAS@nu.edu

Captionist Request Form

Please fill this form out to the best of your ability. Some fields are required before the form can be processed. If you have any questions or need assistance please contact us at dhhsas@nu.edu

Full Name*

First NameLast Name

E-mail*

Student ID*

Subject*

Catalog #*

Class#*

Event Date*

Event Date

Start Time (Pacific)*

:HourMinutesAM/PM Option

End Time (Pacific)*

:HourMinutesAM/PM Option

Service Needed (Please select one. If you are not sure which service would best serve you, please tell us what you are looking for in the 'additional notes' section below)*

Remote Captioning (live, remote class session or meeting)On Site CaptioningClosed Captioning (captioning on an already recorded video, class session, etc.)Transcription (script of an already recorded video, class session, etc.)

Presentation Method*

ZoomIn PersonOther

Address (if applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Room Number (if applicable)

More location details (parking, access points, etc.):

Instructor Name*

First NameLast Name

Instructor E-mail

Additional notes or considerations. If there are varying meeting times, please elaborate here:

* By clicking on the submit form button bellow, I verify that the above information is true and correct to the best of my knowledge. I also acknowledge that have read and understand the Interpreter Terms and Service Agreement and am hereby agreeing to abide by these terms.

Interpreter Terms and Service Agreement

NOTE: This form can only be completed by students registered (i.e., approved for services) with National University’s Student Accessibility Services. Students who are not yet registered with the office for disability-related accommodations and services should visit our website (www.nu.edu/sas) to learn about the process.

Please complete this form to request online or in-person captioning or other class related captioning. This may include teacher/student meetings, group meetings, organizational meetings, on-campus events, or related to class materials. A minimum lead time of five business days is required for single event/date and one month minimum to arrange interpreting for multiple onsite classes. The University will do its best to fill captioning requests; however, it may be impossible to coordinate caption requests made with less notice than outlined above.

You are responsible for providing detailed location information to insure the captionist can assist you in a timely and effective manner.

Student Accessibility Services is open Monday through Friday, 9:00 AM to Friday 4:00 PM; requests made outside these hours may take additional time to fill. Please contact Student Accessibility Services 48 hours in advance of the event/class date for confirmation that interpreting/captioning has been secured.

Student Accessibility Services

858.521.3968 (phone) ● 858.521.3996 (fax) ● DHHSAS@nu.edu