1 Start 2 Complete Campus Event Accommodation Request Form Accommodation(s) Requested * Sign Language Interpreter Captionist Assistive Listening Device (ALD) Furniture & Seating Alternate Media Video Captioning Other Requester's Information First Name * Last Name * Department * Email * Phone Number * Contact Person During Event If Different Than Requester: Name Department Email Phone Number Student's Name, ID and Contact * (If there are multiple students, list all.) Event Name * (only one event per form) Event Description * Event Location * Check In Location * Video Link * Date of Event * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202120222023 Arrival Time * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Start Time * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm End Time * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Accommodation Description * Location of Furniture or Seat at Event * Billing Worktag Additional Comments * You will be contacted within 3 business days. If you have any questions, please contact IVC Accommodations at (949) 451-5811 or ivcaccommodations@ivc.edu. Leave this field blank