MSU > DSO > Notetaking Request Form
You must have an accommodation plan for notetaking services approved by the Office of Disability Services.
First Name:
Middle Initial:
Last Name:
MSU Email:
TechID:
Phone:
Cell Phone:
City of Residence:
May we give your school e-mail address to the student who is taking notes for you in case of questions or clarifications? Yes No
Course ID: (e.g. 004390)
Course Number: (e.g. BIOL100)
Section: (e.g. 03)
Semester: (e.g. Fall 2007)
Course Title:
Credits:
Instructor's Name:
Office Phone:
Department Phone:
Department Interoffice Address:
In the event of short–term illness, injury or disability, please indicate the period for which you would like to request notetaking services. This section is optional.
Start Date: MM/DD/YYYY
End Date: MM/DD/YYYY
Can't see the image? Click for audible version
Please type in the letters you see.
