ACCESSIBILITY SERVICES
CALIFORNIA STATE UNIVERSITY EAST BAY
Hayward (510) 885-3868 | Concord (925) 602-6716 | Online http://www.csueastbay.edu/as
CERTIFICATION AND RULES GOVERNING
RECORDING LECTURES
The Americans with Disabilities Act (ADA) and other legislation requires educational institutions to reasonably accommodate individuals with
disabilities who are qualified to participate in and benefit from educational programs. One possible accommodation for student with disabilities
is the audio recording of classes or lectures to allow for equal access to instruction.
To the instructor: _____________________________________ is a student with a verified disability who is registered with the
Accessibility Services. Based on appropriate documentation, it has been determined that this student’s accommodations
require audio recording classes and/or lectures. By signing the certification, the student agrees to abide by the conditions
below. Please sign to acknowledge receipt of this form and return the top copy to the student.
STUDENT CERTIFICATION
1. I agree that I will not engage in any secret recording of interactions with faculty or during lectures. Any lecture or interaction
with faculty I desire to record, I agree to notify the faculty member and to obtain a written acknowledgement that the
recording is occurring as indicated below. I will provide a copy of this certification to any faculty member whom I am
recording.
2. I agree not to share these audio recordings with any other students, nor to play them for anyone else. I agree that these
audio recordings will be used only by me, and solely in pursuit of my educational program. I agree that I will not utilize these
audio recordings for any commercial or non-educational purpose.
3. I agree that after the conclusion of the class, I will erase the audio recordings within 14 days after issuance of a grade. In the
event that I need to retain the audio recordings after the class has concluded, I agree that I will request permission from the
instructor by resubmitting this form and explaining my reason for retaining the audio recordings. I understand that the
instructor will decide whether I may retain the audio recordings for a longer period, and under what conditions.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------I have read the above statements, understand them, and agree to abide by this certification.
___________________________________
______________________________________
Name of student (please print)
Instructor/Dept./Course & Section Number
_____________________
Quarter & Year
________________________________________________________
________________________
Signature of student
Date signed
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ACKNOWLEDGEMENT OF INSTRUCTOR
________________________________________________________
________________________
Signature of instructor
Date signed
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
REQUEST TO RETAIN RECORDINGS AFTER CONCLUSION OF THE COURSE
I request to retain the audio recordings under the following conditions, and for the following reason(s): ___________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________
________________________
Signature of student
Date signed
________________________________________________________________________________________________________
Decision of instructor
________________________________________________________
________________________
Signature of instructor
Distribution:
Date signed
White – Student
Yellow – Instructor
This form is available in accessible format. Please contact Accessibility Services for more details.
Rules Governing Recording Lectures – 9/12