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Interpreter/Speech to Text Request Form for current or prospective Valencia students

Please make your request at least 72 hours in advance. If you make your request less than 72 hours in advance, we will do our best but cannot guarantee that a service provider will be available.

Please note: if you are a current or prospective employee of Valencia Community College, please make all requests for interpreter/speech to text services to our Human Resources department.

To request a service provider via e-mail:

  1. Please complete the form below.
  2. Click the Submit button on the bottom of the form.

You will receive an e-mail with confirmation that your request has been received and if possible the names of your service provider(s).

If you have any questions, please contact Julie Balassa, Coordinator, Deaf and Hard of Hearing Services.

jbalassa@valenciacc.edu
407-582-2039 voice/tty
407-582-2122 OSD tty

* is a required field.

Requestor Information: (All fields required)

* Full Name:
* E-mail:
* Phone:
(please include area code)
* Please check one -   I am: Current Valencia student
Prospective Valencia student
Family of a Valencia student
* Request:

Interpreter    Speech-to-Text

* Date of Service:
* Time of Service: from   to
* Location (Campus); If an Event off campus check Other box and explain:
East    West    Winter Park
Osceola    Other
* Building/Room Number:
* Description of Event or
Course name and number:
Client Information (if different from requestor):
* Full Name:
* Contact Person:
* Contact Phone:
(please include area code)
Client is: A current Valencia student
A prospective Valencia student
Date of Service:
Campus/Student Activity Request:
Time of Service: from   to
Location (Campus); If an Event off campus check Other box and explain:
East    West    Winter Park
Osceola    Other
Building/Room Number:
Description of Event or
Course name and number: