Data Request Form
Department/Organization:
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone:
*
Status:
*
Faculty
Staff
Student
Other
Other:
Specific Data Requested: What group or cohort is used? What information is needed? (ex: Names and emails of all current Engineering majors, enrollment history for PSYC courses for the past 5 years, etc.)
*
How will the data be used? Who is the intended audience? (ex: ABET accreditation, departmental review, etc)
With whom will the data be shared?
Additional information about request:
Have you discussed this request with your chair or supervisor?
Yes
No
If yes, who is your chair or supervisor?
Please attach any relevant documentation:
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Cancel
of
Please check next to each statement:
*
I understand that this request may take at least 2 weeks to be generated. When practicable, requests will be processed more quickly depending on the complexity of the request and other existing priorities.
I understand that data requests involving sensitive or personally identifiable information may require additional time due to required approval procedures.
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