Disability Resource Center Notetaker Request Form

Student Disability Resource Center Notetaking Service Request

Please submit a separate form for each class for which you are requesting this service.

Fill out form completely or request will be DELAYED.
Refer to the Time Schedule for lecture/section time(s) if necessary.

Fields marked with an asterisk (*) are required

*Date (mm/dd/yyyy)

Requestor's Information

*SUID Number
*First Name *Last Name
*Your initials for labeling notes:
*Phone
*E-mail Address

*Your Disability Adviser/Program Coordinator at the SDRC is

Notetaking Information

Is there a person in class you would recommend the SDRC hire as a notetaker for the class you are taking?
Name
Phone
E-mail Address

*Do you want:
Lecture notes only Lecture & section notes

*Are notes required from the beginning of the quarter? Yes No
If not, from what date do you need notes?
Date

*Are you receptive to receiving your notes via e-mail? Yes No
- If so, do we have your permission to release your Stanford e-mail address to the assigned notetaker? Yes No
( Please note, the assigned notetaker may be someone other than the person you recommended above. )
- If not, please specify a different e-mail address that can be provided to the notetaker.

Course Information

*AXESS Class Number (get from AXESS, e.g. 12345)
*Course Title (e.g. Sleep and Dreams)
*Department
*Course Number (e.g. 101A)

*Day(s) Lecture Meets
Monday Tuesday Wednesday
Thursday Friday Saturday Sunday

*Time lecture starts:
Classroom (Bldg and Room)
Approximate Number of Students in Class

Professor/Instructor Information
Lookup in Stanford.Who

Professor First Name *Last Name
*Phone Number
*E-Mail Address @

Section Information

*This course has (will have) a discussion/problem section Yes No
*I have already been assigned to a section Yes No
If YES, my assigned section number or section day is
My assigned section time is

Teaching Assistant First Name Last Name
Phone Number
E-Mail Address

Day(s) Section Meets
Monday Tuesday Wednesday
Thursday Friday Saturday Sunday

Time section starts:

Additional Comments:

*Do you agree to the Notetaker Services User Contract? You must agree prior in order for us to act on your request.
I agree
I do not agree

SDRC Notetaker Services User Contract

All users of the Notetaker Services are required to read and agree to the following contract. Please indicate that you agree on the online submission form before submitting.

As a user of the Notetaker Service, I agree that:

In order for the service to function smoothly, I will submit my request to the Accommodation Coordinator (AC) as soon as possible.
I will ensure that the information I include on this form is accurate and complete so as to both speed and simplify the process of locating a notetaker.
I will inform the AC of any changes in my schedule within 24 hours. These changes include adding or dropping classes, or modifications in enrollment status such as a leave of absence.
If I have requested notes for sections, then I will inform the AC of my official section number when it is assigned
I will inform the AC of any action that I take to receive notes, including arrangements made with the professor, the teaching assistant, or another student in the class.
I will inform the AC of any problem with receiving notes as soon as possible (e.g. - notes are missing or illegible)
I realize that if I fail to inform the AC of any problems with the notetaking service or with changes in my schedule or status, or otherwise fail to meet the requirements of this contract, the situation may not be resolved by the time of my choosing (e.g. - by midterm, finals)

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