Notes Request - Student Contract
Disability Support Services
Diablo Valley College & San Ramon Campus
DVC (925) 969-2178 / SRC (925) 866-6215
Email: DVC notetakingservices@dvc.edu / SRC auawithya@dvc.edu
DSS Student Signature DSS Staff Signature
This form is available in alternate formats upon request ASL interpreters available upon request
Semester:
1) At the start of class I must present the instructor with an announcement slip so the instructor can assist in finding a note taker.
2) I must abide by all DSS and DVC policies and procedures, including the DVC student code of conduct.
3) I will not receive notes for online classes unless discussed with DSS staff and confirmed that notes are needed for specific times.
4) I understand all notes are delivered to my insite e-mail address, unless I complete an "Allowance for NCR Paper Contract."
5) I can receive notes for classes I am currently enrolled in. If I am wait listed or trying to get into another class I will notify the DSS note
taking coordinator(via e-mail or verbally) to arrange notes for that particular class.
6) I give DSS staff permission to release my contact information to note takers.
7) I must attend class to receive notes, if not I may not receive notes. I will borrow notes from a classmate for days I am absent.
8). I will inform DSS if my instructor provides notes that are sufficient to accommodate my note taking needs.
9) I understand I am responsible for knowing all class assignments, test dates, and due dates.
10) I understand contracts for notes must be renewed each term.
11) I understand it is my responsibility to notify DSS staff if notes are not delivered in a timely manner or are not reasonably sufficient and
helpful.
12) I understand I must go through the San Ramon office to receive note taking accommodations for San Ramon classes.
13) I will notify DSS staff if I add or drop any classes within 48 business hours of doing so.
@insite.4cd.edu
print this form, Sign it and bring it in to the DSS office
I understand all parts of this contract and agree to the conditions and terms as written.
DVC ID #:
Date:
Last Name: First Name:
INSITE Email:
Phone #:
Course Name & Number
Example: ENGL 118
Section Number
Example: 0024
Instructor
Example: Martin, L
SU
SP
FA
