Data/Survey Request Form

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Please complete this form completely so your request can be addressed in a timely manner. Turnaround time on requests is dependent on work load in the office, but is generally not longer than 3-5 business days for data and 1-3 weeks for surveys.

* Name:
* Phone/Ext:
* Email:
* Department/Office:
* Date results are needed:
Please indicate the type of service(s) you are requesting.
(Click all that apply)
Data for report
Data for grant
Data for publicity
Survey design
Other: Specify
Status: Administrator
Select the term for which the data is requested and indicate the needed year:
(Click all that apply)
Academic Year -
(The Official academic year is Summer, Fall, and Spring ex. Academic Year 2016-2017 will include Summer 2016, Fall 2016, and Spring 2017)

Fiscal Year -
(The Official Fiscal Year is C session of Summer, Fall, Spring, and Session A and B of Summer. ex. 2016 fiscal year is C session of Summer 2016, Fall 2016, Spring 2017, and Session A and B of Summer 2017)
Information Requested:
How will requested data be used and of what benefit is it to the college/department/you?
Who will have access to this information?
* Enter word shown below:
* Required Fields

If you entered a valid email address in the form, you will receive an email copy of the information you have submitted. You may retain that as a confirmation of your submission.