OLA Form to Borrow an SIK

Please complete this form to borrow a simultaneous interpretation kit (SIK) from the New York State Office of Language Access.

If you'd like to pick up the kit in person (only available in Albany), submit this form at least 5 business days in advance of the event date. If you'd like us to ship the kit to you, submit this form at least 10 business days in advance of the event date.

1. Contact person for this request: *This question is required.

Name: *This question is required.

Job title: *This question is required.

Agency/Organization: *This question is required.

Unit/Office (write "N/A" if you don't work for a NYS agency): *This question is required.

Work email: *This question is required. This question requires a valid email address.

Work phone number: *This question is required.

Office address: *This question is required.

2. Event details:

Name of event: *This question is required.

Date: *This question is required. This question requires a valid date format of MM/DD/YYYY.

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Time: *This question is required.

Location: *This question is required.

Description (type of event, information to be shared, target audience, expected attendance including language needs): *This question is required.

3. How are you requesting to get the SIK? *This question is required.

Please enter an 'other' value for this selection.

For Shipping: *This question is required.

Date of delivery requested (at least one business day before event is recommended to get acquainted with devices): *This question is required. This question requires a valid date format of MM/DD/YYYY.

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Date for return drop-off (this must be within five business days of event date): *This question is required. This question requires a valid date format of MM/DD/YYYY.

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For Pickup:
Person picking up the equipment: *This question is required.

Same as Contact Person: *This question is required.

Name: *This question is required.

Job title: *This question is required.

Agency/Organization: *This question is required.

Unit/Office (write "N/A" if they don't work for a NYS agency): *This question is required.

Work email: *This question is required. This question requires a valid email address.

Work phone number: *This question is required.

Office address: *This question is required.

Pickup details: *This question is required.

Date (at least one business day before event is recommended to get acquainted with devices):

*This question is required. This question requires a valid date format of MM/DD/YYYY.

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Time (between ____ and ____): *This question is required.

Return Details: *This question is required.

Date (this must be within five business days of event date): *This question is required. This question requires a valid date format of MM/DD/YYYY.

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Time (between ____ and ____): *This question is required.

4. Who will be interpreting for this event? (Please select all that apply.) *This question is required.

Office of General Services language services contractors
Non-contracted vendors
Multilingual staff/volunteers (only for community-based and non-profit organizations)
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

5. Additional notes for OLA: