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Scribe/Reader Request Form
Maintained by drc@ucsc.edu

Disability Resource Center
UC Santa Cruz
1156 High Street
146 Hahn Student Services
University of California
Santa Cruz, CA 95064-1077
Email: drc@ucsc.edu
Phone: (831) 459-2089
TTY: (831)-459-4806
Fax: (831) 459-5064

Office Hours: 8am-5pm, Monday-Friday

Scribe/Reader Request Form

The Disability Resource Center can provide test scribes or readers, as authorized for students with disability-related needs with advanced notice from faculty (at least one week prior to exams if possible).

Scribes are often used to dictate answers to students with broken arms or physical difficulties with writing.

Readers are typically used to read aloud test questions for students with visual impairments or learning disabilities.

Both of these accommodations require that a student be placed in a separate room alone. Faculty are responsible for calling the Disability Resource Center for a scribe or a reader, unless s/he specifically assigns a designate (e.g department assistant) to handle the request. If a designate is assigned, the faculty should clearly communicate with the designate the exam information required for the request (see below). Note: Some faculty choose to use their own resources, such as a T.A, to serve as a scribe or reader.

Date of Request (Required):
   To avoid confusion please use the ISO date format, i.e., YYYY-MM-DD where:
  • YYYY is the year [all the digits, i.e. 2012]
  • MM is the month [01 (January) to 12 (December)]
  • DD is the day [01 to 31]
ex. 2006-06-26
to represent Monday June 26, 2006.
Course (Required):
   To avoid confusion please use the Class ID from the Schedule of Classes, i.e., AMS-3-01, for Precalculus.
Student (Required):
   Enter student's first and last name
Date of Exam (Required):
   To avoid confusion please use the ISO date format, i.e., YYYY-MM-DD where:
  • YYYY is the year [all the digits, i.e. 2012]
  • MM is the month [01 (January) to 12 (December)]
  • DD is the day [01 to 31]
ex. 2006-06-26
to represent Monday June 26, 2006.
Exam Time (Required):
   Please include both the start time and the end time, i.e., 11:30 am/1:30 pm
Exam Location (Required):
   Please provide an exact location, i.e., ClassroomUnit 002, Earth&Marine B210, Cowell Acad 113, etc.
Accomodation (Required):
Scribe
Reader 		   
Type of Exam and Materials Allowed (Required):
For Questions During the Exam (Required):
Department Contact – Name (Required):

Department Contact – Email (Required):

Department Contact – Phone (Required):
    
Faculty Contact – Name (Required):

Faculty Contact – Email (Required):

Faculty Contact – Phone (Required):

    
Exam Pickup Time (Required):
   ex. 11:30 am
Exam Drop Off Time (Required):
   ex. 1:30 pm
Location of Exam Pickup (Required)::
   Please provide the location of the exam pickup if it is different from exam location.
Location of Exam Drop Off (Required)::
   Please provide the location of the exam drop off if it is different from exam location.
Additional Comments: