ASL Interpreter request form

(For a Catholic Mass, Service, or Graveside)

Today's Date

Date

Time

Name of the Deceased *

First

Last

Name of Catholic Church or venue: where the Funeral Mass or service is to be said *

The Catholic Church does not allow a funeral Mass (where the bread and wine are consecrated to become Jesus' precious body and blood) at funeral homes or at cemeteries. We can only provide a funeral service (liturgy of the word, preaching, & prayers) at cemeteries or funeral homes. Thank you for your understanding.

Address of Catholic Church or Venue: Where the Funeral Mass or Service is to be said. *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Date & Time of the Funeral Mass or Service at the Church/Venue *

Date

Time

Is the Church that you are in contact with providing a Deacon or Priest for the graveside service at the cemetery? *--- Select Choice ---NoYes, but I do not need an interpreter for thisYes, BUT I need an interpreter for this. ASL & EnglishYes, BUT I need an interpreter for this ASL & Spanish

If you have not made arrangements with the Church for the graveside service at the cemetery either because you have missed their planning deadlines or for some other reason, would you like to see if we can get a deacon or priest to do the graveside service at the cemetery along with an Interpreter?

• No
• Yes

Name of the Cemetery

Cemetery

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Date & Time of the Graveside service?

Date

Time

Grave number:

Let us know what grave number your family member, relative, or friend can be found. Please add any special instructions to help us make it easier to find it.

I am filling this request for: *

• Myself
• Someone else

Your Name *

First

Last

I am: *

• Immediate Family
• a Relative
• a Friend
• a Church Staff Member or Volunteer
• a Staff Member from a Mortuary or Funeral Home

Your name (Who is filling this form out for someone else) *

First

Last

Email address *

Graveside be the

Phone number *

Name of Deaf or Hard of Hearing Person needing Interpreting Services *

First

Last

Email address *

Phone number *

Upload Funeral Booklet that will be used for the service or Mass. Just drag and drop the files into the shaded box below. Thank you!

Drag & Drop Files, Choose Files to Upload

ASL Interpreter: *

• English & American Sign Language Interpreter
• Spanish & American Sign Language Interpreter

I understand that in requesting an ASL interpreter: We kindly ask for a donation of 100$ to be given to the parish church where the services will be held. The church will give the donation to the interpreter. Your donation suits the occasion, time, and expertise in this special field. If you feel inclined to give a subsequent donation on the day of the services, you may give it to the interpreter directly. Is this agreeable to you?

• Yes
• No

The ASL Interpreter is needed at: *

• Funeral Mass/Service at a Catholic Church
• Place of Visitation ("Viewing" or "Wake")
• Graveside Service at Cemetery
• Place of visitation, Funeral Mass/ Service at a Catholic Church, Graveside service at Cemetery
• Meetings with Mortuary or Funeral Home, Place of visitation, Funeral Mass/ Service, Graveside service at Cemetery

We cannot gaurantee that we will be able to arrange for one of the approved interpreters that the Diocese of Orange recognizes to do the services you are requesting. If we are able or not able to make the arrangement, we will let you know. If you are supplying your own interpreter we kindly ask that they consult with us well-in-advance to-go-over liturgical customs and practices we adhere to. Is this clear and agreeable to you? *

• Yes, I understand: and will comply with the above instructions.
• No

Please add any additional information that you believe may be helpful for us to know. Also, can you tell us approximately how many Deaf persons are likely to attend the Funeral Mass, Service, and Graveside?

Visual Code

Submit

A two week minimum notification is appreciated so that we can properly plan the funeral of your loved one.

Interpreters:

According to Americans with Disabilities Act (ADA), Title III, the funeral home, as a place of public accommodation, has the responsibility to provide interpreting services for the Deaf. (This applies if you are doing the funeral service at the funeral home, not at the Church).

***Please review the “Policy for working with Interpreters in Catholic Religious Settings***

If our local Catholic interpreters cannot be reached or are not available, the family or parish may resort to contracting with the one of the following interpreting agencies:

Lifesigns  888-930-7776  [email protected]

Rise Interpreting 951-565-4422 [email protected]

We ask that in the event a interpreting agency is contracted with: that they reach out to us so that we can provide them with our liturgical norms and customs we adhere-to.