CART Request For Events

* indicates required field.

Payment Information: * Budget number: / or CIF Approval Yes No

Contact Information:

Name:

* NEU Email:

Phone:

V TTY Pager

University Dept:

Student Group:

Onsite Contact:
(if different from above)

Onsite Phone:
(if different from above)

Event Information:

Date:

Start time:

Finish time:

Location:

Who is giving the presentation?

Type of Event:

Please check all that apply.

Workshop / Lecture

Explain:

Group Meeting

Explain:

One on One meeting / interactive

Explain:

Other

Explain:

Materials: Please indicate any materials you will be able to provide us prior to the event.

A script or information packet

A flyer or advertisement

Other

Explain:

Please attach materials (if you have multiple files please zip them up):

Note: If you cannot attach your materials, please send them to the Disability Resource Center in 20 Dodge Hall via interoffice mail.

CART Provider Information:

Preferred CART Providers:

Non-Preferred CART Providers:

If you have any questions contact the Disability Resource Center at x2675 (x2730 TTY).

Disability Resource Center
360 Huntington Ave
20 Dodge Hall
Boston, MA 02115

Phone:617-373-2675
TTY: 617-373-2730
Fax: 617-373-7800