SOURCE_FILE: /home/univtr5/sandbox.univtrans.com/corpus/#22207 Translator Request Form.doc EXTENSION: doc TEXT_CHARS: 4327 ======================================================================== bjbj University Translators Services, LLC INTERPRETER REQUEST FORM EMAIL REQUEST TO: REQUEST@UNIVTRANS.COM FAX REQUEST TO: 734-665-1345 Requested By: Submission Date (Today's Date): 12/6/22 Name (Your name): Martine Highet / Michelle Burns Company / Organization Name: Washtenaw Child Advocacy Center (Phone number / Fax number:: 734-544-2925 / 734-544-2910 Email Address: HYPERLINK "mailto:highetm@washtenaw.org" highetm@washtenaw.org and HYPERLINK "mailto:burnsm@washtenaw.org" burnsm@washtenaw.org Date & Time of Service: Service Date: (write day and date in this box) Monday 12/12/22 Day: MO TU WED TH F SA SU (circle or bold the day your need Wednesday, July 28 at 9:15 am (Start Time: (write start time in this box) 9:15 am (End Time: (or best approximation) 12:15 pm How many hours do you need with the interpreter? 3.0 hours Request Information: Language and Country of Origin: Arabic Name of Limited English Proficient (LEP) Person(s) and their Title(s): Case number # 22207 HA - Child Subject Matter / Charge: Discussion of criminal investigation regarding physical abuse/sexual abuse. Parents speak English but child does not. Will need the interpreter translate before, during and after the child s interview. Type of Meeting/Hearing: In person forensic interview Patient/Case Number: # 22207 Other Participants Names/Titles: Please add or attached pages that include any other information related to your request; the more informed your interpreter is, the better! Location of Services (Where should the interpreter arrive? Who is the contact person for the interpreter?) Company / Organization Name Washtenaw Child Advocacy Center Address/Room #/Courtroom # 555 Towner St City / State / Zip Ypsilanti, MI 48198 On-site Contact Person Martine Highet (On-site Contact Phone Number 734-544-2925 Billing Information (Where should we send the invoice?): Company / Organization Name: Catholic Social Services of Washtenaw County Address: 4825 Packard Rd City, State & Zip Ann Arbor, MI 48108 Attention: Laura Regan (Phone number:/ Fax number: 734- 971-9781 x 312 / 734-926-0615 Email Address: lregan@csswashtenaw.org After we receive and fill your request, a confirmation will be forwarded to you via email. If you do not receive a confirmation prior to the assignment, Please call UTS at 734-665-7295! h 5" uuqqquua h CT h CT h CT h CT h CT ytOEW ytOEW ytOEW }u}u}m h CT h CT h CT h CT h CT gd07{ ytOEW gd CT h07{ h CT h CT hwCY hwCY h CT h CT h CT h CT gd07{ pf\RfRR hwCY h CT h CT h CT h07{ h CT h07{ h CT hwCY h07{ h CT h07{ gd07{ gd07{ yt07{ aTM;; h CT h07{ h CT hwCY h07{ {{{w{{{{sohw{{{w{{ h CT h CT h CT kd1 h CT h CT h CT h CT h CT h CT ha!2 ha!2 gdIRx IHDR gAMA PLTE pHYs IDATx `[.( {wXBr OP|t `ECB YtA) D1OF! X7u+VMS IEND ytOEW ytOEW ytOEW ytOEW yt07{ ph`^\ [Content_Types].xml _rels/.rels theme/theme/themeManager.xml sQ}# theme/theme/theme1.xml "GJK TcKBc v[`E '.Lq yDQ"Q Z6/H ud9c J{rJ Q/B)L lC=h W!alf AXl:X PxzSq]y UNIVERSITY TRANSLATORS SERVICES, LLC Raquel Fleming Normal.dotm Michelle Burns Microsoft Office Word University Translators Services UNIVERSITY TRANSLATORS SERVICES, LLC Title _PID_HLINKS Microsoft Word 97-2003 Document MSWordDoc Word.Document.8