Note Taker Agreement Form

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I agree to volunteer for Dominican University of California's Accessibility and Disability Services Office (ADS) as a classroom note-taker. I agree to provide my classroom notes to the ADS for sharing with a peer. I understand and agree to follow the procedure below:

1. I will attend classes as scheduled. If I am absent from class, I will make reasonable effort to inform both the instructor and ADS so that alternative note taking arrangements can be made.

2. I will take clear and comprehensive notes to the best of my ability.

3. I will provide a copy of my notes to the designated person/department (that I will indicate below in this agreement) in a timely manner, preferably between 24 to 72 hours.

4. Should I be approached by the student for whom I am taking notes, I will keep his/her/their accommodations to have a note-taker confidential.

5. If I have any questions or concerns, I will contact ADS by email (accessibility@dominican.edu) or call them at 415-257-1388.

Email *

By selecting "I Agree", I acknowledge that I have read the above Note-taking Procedures and agree to follow them as a Note-taker for Dominican University of California. *

I Agree

Required

Your First name: *

Your Last name: *

Your Student ID#: *

Your Dominican email address: *

Best contact number: *

Term: *

Class name and section (example: Math 1210): *

Days/time (example: MW 8:30am - 10:10am) *

Class location (example: Guzman 202) *

Professor's name (example: John Smith) *

Please indicate the format you plan to deliver your notes: *

A hard copy of notes will be given directly to ADS (copy will be made free of charge in the ADS office)

An electronic copy of notes will be emailed directly to ADS (e.g. WORD document, scanned copy of notes, pictures of notes)

An electronic copy of the notes will be uploaded to an online file sharing platform (e.g. Google Drive, Dropbox) where it will be shared with ADS

An electronic copy of the notes will be uploaded to an online file sharing platform (e.g. Google Drive, Dropbox) where it will be shared with the STUDENT.

Other

If "Other" was selected, please explain the alternative method of delivery:

Please type your name as an electronic signature here: *

Today's date: *

YYYY

Send me a copy of my responses.

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