Request an ESS Interpreter
Per FERPA, please use your work (school) email when filling this form out.

Please fill out the information below and click on the "Submit" button. Request an ESS interpreter at least seven (7) business days prior to the meeting/event. CLSO staff will confirm the request with the contact person listed below.

We will accommodate short notice requests (same day or less than two business days notice) based on availability and level of urgency, for such requests please call Abigail Molina, Student Language Services Coordinator, at 303-326-4463 or X: 27828.

Email address *
Language requested *
What language do you need to interpret for
Requesting School *
Please List Your Location Name
Location Address *
Please List Your Location Address
Your answer
Contact Person *
Your answer
Title/Position *
Your answer
Phone and/or Extension (please include direct line or cell phone) *
Your answer
Last Name of Person Receiving Services *
Student's Last Name Only
Your answer
First Name of Person Receiving Services *
Student's First Name Only
Your answer
Role of Person Receiving Services *
Description Request *
Required
Evaluation Type
If you are requesting an evaluation, please enter the type of evaluation here.
Your answer
Date of Service *
If your request is less than 7 working days, there is no guarantee that we can assign an ESS Interpreter
MM
/
DD
/
YYYY
Starting Time *
Time
:
Ending Time *
1 Hour Minimum
Time
:
Additional Comments
Please only use this section to provide information about the meeting that may be helpful for the interpreter to know before arriving to the meeting. If a call to the family needs to be made, please use the TeleLanguage or CTS Language Link (phone interpretation) services provided by an account created by your school. If additional support is needed please contact Abigail Molina at X: 27828. Thank you!
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of APS Google. Report Abuse