Sport Manitoba - ASL Interpretation Services Request Form

ASL Interpretation Services Request Form

Sport Manitoba provides ASL interpretation services to support Manitoba participants/coaches/officials participating in integrated sport programming based on the following general eligibility criteria.

Participant Eligibility Requirements:

Sport activities must be affiliated with Provincial Sport Organizations (PSO) recognized by Sport Manitoba. See below for eligible sports.
The program/league /club you are participating in must be registered/affiliated with a recognized PSO. (ie Manitoba Volleyball, Soccer Manitoba)
The program must be structured, ongoing and must take place in Manitoba (ie league, club program)
Funding is provided directly to the interpreter or interpreting company.
Applications must be received before the program begins. Funding cannot be provided for programs that have already been completed.

Please review the Provincial Sport Organization (PSO) listing link below prior to completing the application to ensure the program is recognized by Sport Manitoba.

PSO Listing - https://www.sportmanitoba.ca/partners/

* Please note the submitting an application does not guarantee funding

Respondent*

You will receive a confirmation of receipt of the application by email. This is not an approval of the application.

First name *

Last name *

Email *

Mobile

Deaf Participant Name (list all if more than 1) *

Deaf Participant Name (list all if more than 1)

Deaf Participant Age (if under 18 yrs old) *

Deaf Participant Age (if under 18 yrs old)

Which Sport are you requesting ASL Interpretation Services for? *

Which Sport are you requesting ASL Interpretation Services for?

Name of Program/club/league *

Name of Program/club/league

Who is running the program? (ie. MDSA, Baseball Manitoba, Springers Gymnastics Club) *

Who is running the program? (ie. MDSA, Baseball Manitoba, Springers Gymnastics Club)

Provide an explanation of the program *

Provide an explanation of the program

Location of Program - Facility Name ( ie Pan Am Pool) *

Location of Program - Facility Name ( ie Pan Am Pool)

Location of Program - Address (street name and number) *

Location of Program - Address (street name and number)

Date(s) and time of Program (please list all dates and times) *

+ Add

Number of Sessions (# of weeks, days etc) *

Number of Sessions (# of weeks, days etc)

Number of Interpreters Required *

Please indicate if you have a preference for a specific Interpreter (first and last name)

Detailed Cost Breakdown of Interpreters (ie. 10 sessions X $70= $700) *

Detailed Cost Breakdown of Interpreters (ie. 10 sessions X $70= $700)

Total Projected Request *

Total Projected Request

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