Contract for Note Taking Services
Complete and submit form to Learning Support Services, located in Clark Hall 226, or UC Box A111 at the time of hire.
Please carefully read the following and sign below. This contract is valid for one academic semester. Please print legibly in
black or blue ink.
Name: _________________________________________ Student ID #:
Local Address:
STREET
Phone:
CITY
Email Address:
A&S
Graduate/Professional Programs: Specify program
Semester:
Fall
Winter 3
Course Number:
ZIP
UC Box #:
Program:
Spring
STATE
Summer
Year:
Title:
Credits:
I. CONTRACT WITH STUDENTS:
A. Complete one Notetaker/Student contract for each class identifying the number of students with learning disabilities in the
course and arrangement for the delivery of notes.
B. Keep confidential all information regarding students with disabilities who are receiving services.
II. CONTRACT REQUIREMENTS
A. Show up to each scheduled class on time.
B. Stay the entire class period.
C. Adhere to the schedule for delivering notes per the Notetaker/Student contract.
D. Arrange for a substitute to take notes if you can not attend due to an illness or emergency.
E. Stay in contact with the student. It is preferred that you contact the student weekly.
F. Request feedback on the quality or format of notes.
G. Give the professor information regarding Learning Support Service's notetaking services.
H. If student is absent from class, the notetaker is not required to deliver those notes to the student, unless the student has
an excused absence. (check with professor to discern whether absence is excused).
III. COMPENSATION
A. Pay is $10 per credit per class.
B. Upon hire, please complete Form I-9 Employment Eligibility Verification and Form W-4. Both forms must be submitted
to Human Resources to receive compensation after the semester has ended.
C. You will receive a 1099 by the end of January of the following year and are responsible for paying all taxes.
D. If the student drops or withdraws from the class, it is understood that your notetaking services will no longer be needed.
Your pay will be prorated from the day the student drops or withdraws from the class.
E. If you are taking notes for more than 3 students in a class, you will receive additional $25 compensation.
F. If performance is less than satisfactory, your services will be terminated. Pay will be prorated from the time the decision
to terminate has been made by the Director of Learning Support Services.
I understand that I am contracting with Pacific University to provide notes to a student(s) with a disability. I
understand my responsibilities and agree to provide notes according to the above requirements.
SIGNATURE
For office use only
DATE
Date received by LSS
(0/2009) Notetaker Contract)
Date submitted to HR
Client Initials