Institutional Research and Assessment Service Request Form
* Required question

1) Type of request*:
Institutional statistics TK20/assessment
Program-level statistics Peer data/benchmarking
Survey/research study Other, specify

2) Primary purpose*:
Accreditation Program development Internal reporting
Assessment Planning Grant application
Program review External reporting Other, specify

3) Student/employee categories to include: [Check all that apply]
All students Full-time day undergraduate Full-time faculty
All undergraduate Full-time adult undergraduate Adjunct faculty
All graduate Full-time graduate Other, specify
All day undergraduate First-time full-time freshmen (cohort) N/A
All adult undergraduate New full-time transfer cohort

4) Time range: [Check all that apply]
Current year fall (Oct 15) Current year spring (Mar 15) Other, specify N/A

5) Project requirements*:
[Describe in detail]

6) Department requesting*:
If other, specify
Contact e-mail
Contact name
Date submitted (mm/dd/yyyy)
Date needed (mm/dd/yyyy)*

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