Michigan Works! Southwest is available to help you get back to work! To get in touch with a staff member, please call your local service center. Click the link below for contact information.

RESOURCES AND CONTACT INFO

Language Assistance Request Form

DATE: ____________________

 

PERSON REQUESTING LANGUAGE ASSISTANCE:

Name:  ___________________________________________________

Address:  __________________________________________________

Phone Number:  ____________________________________________

Email:  ____________________________________________________

 

LANGUAGE ASSISTANCE REQUESTED:

  • I want the Michigan Works! Southwest Agency to provide an interpreter for me at no cost to me or my family.

 

  • English is not my primary language.
  • I need an interpreter for the following language: _____________________________

 

IF REQUEST IS FOR A SPECIFIC APPOINTMENT:

Date Assistance is Needed: _______________________________________________________

Time Assistance is Needed:  ______________________________________________________

REQUEST IS FOR:     _____ This Appointment Only                     ______ All Appointments

 

SIGNATURE: _______________________________________

 

Completed form “Language Assistance Request Form” must be returned to:

 

Jakki Bungart-Bibb, Equal Opportunity Office

Michigan Works! Southwest

222 S. Westnedge Ave

Kalamazoo, MI 49007

(269) 385-0457

Bungart-Bibb@upjohn.org

 

Download PDF

We can help you prepare for and find a job.

Staff Login Board Login Locations

A proud partner of the American Job Center network.

An equal opportunity employer / program supported by the State of Michigan. 1-800-285-WORK (9675).
Auxiliary aids and services are available upon request. Dial 711 Relay Center and TTY.  Supported in part with state and/or federal funds.