Your Agency: (read only)

If you do not see your agency name on this list, please contact us ASAP, 503-502-2386 or
At lease one week notice is recommended in order to fulfill your request.

WorkOrderID #: (read only)
Contract #: (read only)
Cost Control #:
Your Name:
Department/Burueau/Unit (if applicable):
Job Title:
Your phone #:
This request is approved by (name of supervisor):

Services Date: (yyyy-mm-dd)
Request services from CELS pertaining to:
Language Needed:
Name of CELS liaison:
Where service is needed:
  • Name of location:
  • Address:
  • City:
  • State:
  • Zip:

Length of service needed (minimum 2 hour, with 15 minute increment thereafter):
Total Hour(s):
Expected number of attendees: (including staff members and clients)

Target Audience(s): (check as many as apply)
    Community with disabilities
Type of event:

This service is directly requested by:
Any early preparation needed before the meeting date:
Yes       No

    If yes, what type of preparation:
    Special Request/Instruction

    How many hour(s):

    Please attach any documents for CELS member to prepare for this service here (note: your agency will be billed for the prep work aside from the site services):

Detail (bullet point):
Yes, I have read and agreed to the terms indicated on-site services. I am fully responsible for this work request and I understand my agency or any fiscal agency dealing with my request will be billed for the hour said above. Cancellation less than 48 hours will be billed at minimum 1 hour.

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