District Captioning Request Form

—For DECT Approved Classes—

(Distance Education Captioning & Transcription)

Deaf or hard-of-hearing student currently enrolled in class.

Title II of the ADA and Section 508 of the Rehabilitation Act require that students with disabilities have access to printed and computer-based information. Instructional materials in “alternate format” include captioning videos and transcribing audios (e.g. podcasts) for deaf and hard-of-hearing students.

1.  / Faculty/staff member provides video clip (on DVD) that needs to be captioned, or audio file (on CD) that needs to be transcribed. Acceptable formats include:
.avi (Audio Video Interleave) .Avi files must already be compressed.
.flv (Flash Video) .Flv (original project) files are acceptable, but not .swf (Flash Movie) as they cannot be edited during the captioning process.
.mov (QuickTime) .wmv (Windows Media Video)
.mpeg (Motion Picture Experts Group)
.mp3/.mp4 for podcasts
2.  / Faculty/staff member completes one form for each video/audio clip “title” and sends (with the original DVD/CD) to their ATS (Access Technology Specialist) or campus designee.
3.  / Campus Designee Contact Info — Name, Phone, etc:
4.  / Note re: video clips that qualify for DECT funding — Providing an electronic transcript of the audio portion is not required. DECT will also cover the costs for transcribing the audio content of all videos that are approved for captioning.
FACULTY (OR ATS/CAMPUS DESIGNEE) — PLEASE PROVIDE THE FOLLOWING INFORMATION:
Date: / Requestor’s Name and Phone Ext.:
Requestor’s Position Title and Department:
Title of Video/Audio Clip:
Video Copyright Owner/Producer’s Name:
Length of Video (10-min Max Recommended): / min. / Year Produced:
The Following Class Info is Required By DECT) --- / Course Title:
5-digit CRN/Section # : / Anticipated Enrollment: Count
Delivery Mode: Online Hybrid Telecourse Interactive Video Other (Specify)
Type of Media: Audio Video PowerPoint Slides Animation Other (Specify)
Charge Captioning Costs to the Following Budget Number: / DECT Grant Funds
After captioning/transcribing requests are completed, materials will be sent back to the ATS /campus designee, unless otherwise indicated on the next line (below). The ATS will return the materials to the original requestor.
Return Original Materials to: / Department/Room #
Additional Information
Access Technology Specialist
ATS/campus designee must verify that all pertinent information is provided on this form......
ATS/Campus Designee Name: (Please Type, Print or Sign Legibly)
Captioning Staff Use
Date Received: / Name: (Print or Sign Legibly)

Revised January 14, 2011