Survey Request Form

Saturday, April 20, 2024

Use this form to submit a request for survey approval. Provide detailed answers to each of the questions below and upload the required documents.

After reviewing your form submission, the Office of Institutional Research will contact you if any additional information or consultation is needed.

Upon approval of survey proposal, IR will assist in survey design, logistics, analyses, etc.).

Items marked with * are required.

Date: *

Requestor Name: *

Unit/Division/Department: *

1. Survey Title: *

2. Please identify the target population (e.g., prospective students) *

3. What is the purpose of the survey? *

4. When will the survey be administered? (include deployment and end dates) *

5. How will the survey be administered? (electronic administration is highly recommended) *

6. Will responses be anonymous, confidential, or neither anonymous nor confidential? *

7. Who will receive copies of the survey results? (include any committees or college groups) *

8. How will survey results be used? *

9. Upload drafts of the (1) cover letter/email, (2) instructions for respondents, and (3) any drafted survey questions. *