DATA REQUEST FORM

DATA REQUEST FORM

Institutional Research Office~Administration Building ~ 3rd Floor~363B
Minot State University requires the submission of this form for ALL data requests. Data requested may be readily available on the Institutional Research Web site, please verify PRIOR to submitting the Data Request Form at

http://www.minotstateu.edu/instplan/
Date Submitted:

MonthDayYear
Date
Date Needed:

MonthDayYear
Date
Type of Request:*

One -Time RequestWill need data again
Name:
Department:
Job title:
E mail:
example@example.com
Phone:
As an MSU employee responsible for the data request outlined below, I recognize that unauthorized use of this data could be a violation of FERPA guidelines and lead to subsequent denial of future data requests.
Signature*

First NameLast Name
Describe data requested:include selection criteria, sequence preference. Please be specific.*
Use and purpose of the data requested. Who will use the data. How will the data be protected to ensure confidentiality according to FERPA.*
Please allow 3-5 business days for an e-mail response to this request.
Should be Empty: