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Disability Services Request Form
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TYPE OF SERVICE REQUESTED
Sign Language Interpreter
(check all that apply)
American Sign Language
Manually Coded English
Cued Speech
Oral Interpreting
Tactile Signing
Assisted Listening Device
Please indicate location where device is needed and room number if applicable
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Senate Committee Room (A,B,C,D,E,F)
House Chamber
Senate Chamber
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Braille Print and Large Type Print
Braille Grade 1
Braille Grade 2 (most common)
18 Point Type
DATE SERVICE NEEDED:
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