Note-Taker Request

To download and print a pdf click here.  Please return to Deborah Levi in the SMC Campus Center, Rm 317

CONTACT INFORMATION
CLASSES
Please include your class number and name, instructor name and email
I AGREE TO THE FOLLOWING STATEMENTS:
1. At the start of every semester, I will communicate with the ESDS staff and submit a request for a note-taker.*
2. I will attempt to take my own notes and will use the note-taker’s notes as a supplement.*
3. I understand that having a note-taker is not a substitute for class attendance. I am still required to attend class and understand that excessive absence that is not disability-related could jeopardize the receipt of notes.*
4. If I drop a class or change my schedule, I will inform my note-taker and ESDS immediately.*
5. If I have problems with the note-taking process, I will notify the ESDS immediately. I bear responsibility for letting the ESDS know if I am not receiving notes.*
6. I understand that the notes provided to me are for my study purposes only, and not for distribution to other students.*
7. I understand that despite their best efforts, note-takers may be absent for some classes during the course of the semester. The note-taker will attempt to find a substitute note-taker, but it is not guaranteed. It is recommended that I devise a back-up plan for obtaining notes in the absence of a note-taker.*
8. I will communicate with the ESDS office regarding my comfort level of disclosing my identity to note-taker. I will discuss how I will be receiving notes for the semester with ESDS or the note-taker.*
9. I understand that my name and contact information may be provided to the note-taker. The ESDS does not share information related to students’ disabilities.*
AUTHORIZATION AND SUBMITTION:
By clicking "Submit" I verify and agree to the above statements and understand my responsibilities.