DEAF SERVICES CENTER, INC.
Community Resources Department
5830 North High Street
Worthington, OH 43085-3959
(614) 841-1991 Voice/TTY (614) 841-4909 FAX

Presentation Services Data Sheet
Company/Organization:
Contact Person:
Contact Date:
Address (of workshop):
City, State, Zip
Telephone:
Fax:
E-mail Address:
If billing address is different from above, please indicate that address below:
Date and time frame for this presentation (i.e. number of hours, time of day, day of week, etc.)

Please check all categories of interest to be included in presentation:
American With Disabilities Act
Public Law 504
Deafness/Deaf Culture/American Sign Language 		Community Resources for Deaf Persons
Interpreters/Interpreting issues
Assistive Devices for the Deaf
Communication Issues/Working With People Who Are Deaf
Impact of Deafness on Education, Employment, Social and Psychological Aspects
Other, please specify:

Description of the audience and/or special needs (i.e. one on one; small group (6-12); large group (12-15); assembly (25 or more); group consists of children, students, adults; group is deaf or hearing; etc.)

What would you like this presentation to accomplish?



When you click the "Send Form to DSC" button above, the Community Resource Department will receive the form.  If you want a copy of this form, you can print this page. You can use the printed form to mail or fax to the department if you prefer. The mailing address is shown at the top. The fax number is (614) 841-4909 Attn: Speakers Bureau.

Upon receiving your request, the Community Resource Director will respond back within 48 business hours. If you do not receive a response back please contact us at (614) 841-1991 TTY/Voice

Thank you!       back to top      back to Speaker Bureau main page

 :