Pressley Interpreting Request

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This form may be used for an interpreter request 2 weeks in advance or more. If the request is for a job in LESS THAN 2 WEEKS, this form MUST be accompanied by a PHONE CALL or TEXT MESSAGE to 412.719.4826

Email *

Email address *

Title of Event (name of training, type of meeting, etc.) *

Will this event be recorded for re-showing at a later date? *

Yes

Maybe

Required

Language *

American Sign Language

Spanish

Other:

Date of Event *

YYYY

Start Time *

Time

End Time *

Time

Repeat Event? List more dates/times here.

COMPLETE address *

530 Marshall Ave, Pittsburgh, PA 15214 (specify building/room next)

514 Marshall Ave, Pittsburgh, PA 15214 (new school building at 530 Marshall)

5500 Corporate Dr., Suite 400, Pittsburgh, PA 15237

2611 Stayton St, Pittsburgh, PA 15212

1400 Ingham St, Pittsburgh, PA15212

Other:

Required

Building, room, other location information

More info if needed (eg. parking, security, dress code...)

Name(s) of non-English Speaking Client(s) *

Role of Client *

Participant

Presenter

Meeting Lead

Other:

Required

Other People Attending (list names)

ON SITE Contact Person's Name *

ON SITE Contact Person's Phone Number *

Would you like to request a specific interpreter? (list names, descriptions, skills needed below - depends on interpreter availability)

BILLING INFORMATION

The next section relates to billing only. It we already have your billing information on file, just type ON FILE in the box. If this is a first time request, or your billing information is different, please fill out all the information below.

Cost Center *

PRSD Education Only (staff/students attending are all from the school)

PRSD Residential Only (staff/students attending are all from the dorm)

PRSD Ed & Res (mixed group or staff person attending is 50/50)

Other (complete billing info below)

Required

If you are planning to record the interpreters during your event, please include that information at the beginning of this form. Understand that if the interpreters are recorded, there are additional fees for recording the interpreters. If you are recording for your own purposes without the intent to utilize the interpreter, I can negotiate fees with the interpreter. If they are recorded without my prior knowledge and their consent, you will be charged the video fees. *

I understand that recording the interpreter's image for future use will result in a charge double the rate of the interpreter.

Required

BILLING CONTACT (name, email, phone)

Billing instructions (include cost center, where to send invoices, etc.)

We abide by a 24-hour cancellation policy. Once your event services have been confirmed, you must cancel at least 1 business day in advance to avoid any charges. To cancel less than 24 hours in advance, please call or text 412.719.4826. To cancel further in advance, forward your confirmation email with the subject CANCEL to AMcquillan@PressleyRidge.org. *

I understand that I will be charged the total negotiated rate unless I cancel services at least 1 full business day in advance.

Send me a copy of my responses.

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