Printable Form Student Contract If you plan to miss class, you must fill out the Student Schedule Change Form Lisa Hitzler Supervisor of Interpreters Phone: 480-461-7327 Email: firstname.lastname@example.org Christopher Slayton Technology Support Specialist | DRS Phone: 480-461-7939 Email: Christopher.Slayton@mesacc.edu Mora Shahan Administrative Secretary Phone: 480-461-7395 email@example.com Important to Note: Notify the Interpreter Coordinator that you will miss class at least 48 hours in advance. Notification between 48 hours and 1 hour before the class is considered a LATE NOTICE. Missing class without notification is considered a NO SHOW. Three (3) LATE NOTICES is considered one (1) NO SHOW. Three (3) NO SHOWS and your services are subject to suspension. A letter of warning will automatically be sent and you will need to make an appointment with the Interpreter Coordinator. Interpreting services will resume when a valid explanation is provided during the appointment. Examples of valid explanations for absences can be found in the MCC student handbook. Interpreters and Captionists will wait 5 minutes per half-hour of class time with a minimum of 15 minutes and a maximum of 45 minutes. Interpreter Coordinator has the right to suspend/cancel services if no communication occurs. Please complete all information and click once to submit: I have read the Student Contract and specifically agree to all provisions contained within. You must agree to the terms to request services. Today's Date Student Information Student's Name Student's Email Student's Contact Number Assignment Information One-Time Assignment? Yes No Purpose of Request Tutoring Meeting Class Other Service Information Start Time AM PM End Time AM PM Day of Week Month/Day/Year Location The student agrees to the following guidelines: I will submit a CART REQUEST FORM for each time that I need to have an captionist for special assignments. This is other than my regular captionist scheduled in my regular classes. Each CART REQUEST FORM that I submit shall be completed, signed, and dated. Each form shall be completed and submitted to the DRS office a minimum of four (4) working days, excluding weekends, PRIOR to the day the captionist is needed. In the event of a change in the test date or time, I accept responsibility for notifying the DRS office of the change by altering and initialing this form within a minimum of two (2) working days prior to the event/test date. By submitting this form, I acknowledge that I have read and understood the guidelines. I understand any changes to the CART request must be notified to the DRS office as indicated within the guidelines. I understand that the lack of information provided in this form may result no action until all information is filled out.