BSL INTERPRETER REQUEST FORM
DETAILS OF ASSIGNMENT |
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| Name of Organiser/Contact |
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| Tel No: |
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| Email: |
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| Name of Deaf Person (s) Attending: |
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| Tel no: |
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| Email: |
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| Deaf person's preferred method of communication i.e BSL, SSE: |
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| Date (s) of Assignment (s): |
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| Time: |
FROM
TO
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| FULL NAME OF VENUE: |
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| CONTACT PERSON AT VENUE: |
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| TELEPHONE: |
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| EMAIL: |
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| FULL POSTAL ADDRESS (including Postcode): |
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| DIRECTIONS: |
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| PARKING: |
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| If venue is hard to find, please include directions and any landmark details etc |
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NAME OF NEAREST TUBE/TRAIN STATION:
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TYPE OF ASSIGNMENT (s)
Meeting, Training, Conference, Interview etc... Please include title and subject: |
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Medical Appointment, GP/Consultant?
In or Out Patient?
Doctor’s Name?
Nature of Medical situation? |
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Other: please include any details not mentioned above: such as whether there will be a co-worker or
not, and how many people." |
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| NO OF INTERPRETER(s) REQUIRED: |
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| DRESS CODE: |
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| I have read and accept the Terms and Conditions (Please check box to continue) |
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| More details will be required once the booking is made such as
the invoice, address etc... |
