Search

Disability Resource Center

Students
Guide to Accommodations
DRC Access Testing
Faculty
Report an Issue

About
DRC Staff
Frequently Asked Questions (FAQ)

UIC.edu
Campus Map

Disability Resource Center

View Menu

Disability Resource Center
Students
Current DRC Student
Peer Note Taker Request Form

Peer Note Taker Request Form

Students who are approved for the accommodation of a peer note taker should complete the form below in order to set up services for the semester.

Request A Peer Note Taker Heading link

Name * Required
First Last
Email * Required
What format will you need your notes in? * Required
- Word document
- PDF
- Any format (photo, screen grab, photo copy)
For how many classes will you need a peer note taker? * Required
- One class
- Two classes
- Three classes
- Four classes
- Five classes
Class # 1 Name and Number * Required

Ex) ACTG 210
Class # 1 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 2 Name and Number * Required

Ex) ACTG 210
Class # 2 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 2 Name and Number * Required

Ex) ACTG 210
Class # 2 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 3 Name and Number * Required

Ex) ACTG 210
Class # 3 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 2 Name and Number * Required

Ex) ACTG 210
Class # 2 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 3 Name and Number * Required

Ex) ACTG 210
Class # 3 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 4 Name and Number * Required

Ex) ACTG 210
Class # 4 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 2 Name and Number * Required

Ex) ACTG 210
Class # 2 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 3 Name and Number * Required

Ex) ACTG 210
Class # 3 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 4 Name and Number * Required

Ex) ACTG 210
Class # 4 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required
Class # 5 Name and Number * Required

Ex) ACTG 210
Class # 5 Note Taker Options * Required
- I know someone in the class who I would like to be my note taker
- I will need the DRC's assistance in identifying a note taker for this class.
(Please choose one.)
Please provide the UIC email address of the note taker you have identified. * Required

Students

New DRC Student
- UIC Affiliated Diagnostic Referrals
Current DRC Student
Prospective Students
- Technical Standards
Professional Students
- Technical Standards
- Information for Medical Students
Temporary Injuries

Contact

1200 W. Harrison St., 1070 SSB Chicago, IL 60607: Open M-F, 9-5

Phone: (312) 413-2183 (main office), (312) 413-4811 (testing)

Fax: (312) 413-7781

Social Media Accounts

UIC.edu links

UIC.edu
Academic Calendar
Athletics
Campus Directory
Disability Resources
Emergency Information
Event Calendar
Job Openings
Library
Maps
UIC Safe Mobile App
UIC Today
UI Health
Veterans Affairs
Report a Concern

Powered by Red 3.0.51

© 2024 The Board of Trustees of the University of Illinois | Privacy Statement

Campuses

University of Illinois System
Urbana-Champaign
Springfield
Chicago