SERVICES
DEAF
BUSINESS
INTERPRETER
OUR STORY
CONTACT US
REQUEST
SERVICES
DEAF
BUSINESS
INTERPRETER
OUR STORY
CONTACT US
Hawaii Interpreting Services
REQUEST
Request A Service
If you are a returning customer, please log
your account
in.
Name
*
First Name
Last Name
Company Name
*
Dept, Unit, Branch
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Phone
*
(###)
###
####
Assignment Service
*
Please select one
Interpreter
Captioner
Date
*
Date of service needed
Start Time
*
Hour
Minute
Second
AM
PM
End Time
*
Hour
Minute
Second
AM
PM
Assignment Type
*
Please select one
Business
Educational
Legal
Medical
Social Services
Other
Assignment Location Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Island
*
Please select one
Oahu
Hawaii
Kauai
Maui
Molokai
Other
Parking Information
*
Please provide the information of parking where the interpreter can park for the assignment.
Point of Contact Name
*
Point of Contact Phone
*
(###)
###
####
Consumers Name
*
Deaf Consumers Name
Deaf Persons Language Preference
Please select one, if known
ASL
Hawaiian Sign Language
Signed English
Mixed
Other
Billing Name
*
We offer a variety of payment options including check, credit card (Mastercard, Visa, American Express), and P-Card, Payable upon receipt of invoice through our secure site Gridcheck.com
Billing Phone:
*
(###)
###
####
Billing Email
*
Billing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Additional Comments
*
I agree to all the Terms and Conditions listed below and I am authorized to approve payment.
*
Submitting this form begins your registration process. It does not guarantee services. When your registration has been received, we will also email you our Service Agreement. Hawaii Interpreting Services respects the security and privacy of its customers and service providers. We will never share your information without your permission. By submitting this form you authorize us to create your account with Gridcheck.com, our secure scheduling and management site.
Thank you!
