An instructor standing at a whiteboard addressing a small circle of seated students
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Inclusion Through Accountability: Using a Receipt of Syllabus Form

In April, I attended the Center for Faculty Advancement’s Inclusive Teaching workshop. During this session, participants discussed the question of cultivating an inclusive learning environment while affirming student accountability.

One strategy I have found effective is the receipt of syllabus or course acknowledgement form, which I use in my courses at NYU College of Dentistry. A version of this form was first introduced to me while I was a student in my doctoral program several years ago. As both a student and now a professor, I have found this tool helpful in prioritizing student voice while also establishing mutual commitment to course expectations.

Here are the steps for creating your own receipt of syllabus form:

Step 1: Identify several statements that you want to emphasize in your syllabus. These statements could concern course structure or format (whether face-to-face, remote, or hybrid learning); office hours and contact information for the instructor; assignment due dates; attendance and grading policies; and course objectives. You can also highlight specific services (for example: the Moses Center for Student Accessibility, student health and wellness services, or writing support services).

What you choose to emphasize is up to you, but consider including positive language about best practices for success in the course (for example: “One strategy for doing well in this course is to review my daily email for instructor updates”).

Step 2: List these statements at the end of your syllabus with a line next to each for students to initial.

Step 3: Have students fill out the form by initialing each statement and signing and dating the bottom. Make sure students understand that by doing so, they attest to having read and agreed to each statement.

Step 4: Collect printed copies of the completed forms from students within the first week of class. I assign the form a small grade and deduct points for lateness to emphasize its importance.

Throughout the semester, my students and I refer back to the receipt of syllabus form as needed, reminding ourselves of our agreed-upon community guidelines and affirming a sense of student-ownership over their learning. In my experience as both student and instructor, the receipt of syllabus form has proven an indispensable tool for supporting an inclusive learning environment.


Donna Catapano, DHSc, RDH, CDA, is a Clinical Assistant Professor at the NYU College of Dentistry.