(Questions marked with a
Your telephone number:
Department / Program:
Is your supervisor / manager aware of this request?
1. What type of project is this request for?
State or federal reporting
Grant proposal program
Shared Governance, advisory, or committee group
Program, course, or department-level project
2. What is your research question(s)?
Ex: My students pass my class, but are they graduating? How long does it take them to graduate?
3. What information is needed to help answer the research question?
Consider the following factors:
-Time period of assessment
-Courses to be tracked
4. How will this research or information be used? Check all that apply.
Discuss the results with others
Develop additional questions to explore based on the results
Make changes to a program or service
Use the data to inform decision making
Apply for a grant or grant reporting
Use the data for planning purposes
Use the data to establish goals and/or benchmarks
Evaluate a program
Develop interventions or strategies
5. How often do you anticipate this request will need to be filled?
6. When is the data needed? Please note, we ask that all requests be submitted at least 2 weeks in advance.