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Request for Institutional Data or Research Services

Please provide as much detail as possible so we can help determine what data or services will fulfill your request. If you have any questions about
this form or the information you would like, you can contact our office prior to submission of the request (email llongo@brookdalecc.edu). Please give
as much notice as possible when requesting data. Some requests take longer than others depending on the nature of the data.
Planning and Institution Effectiveness will consult with the Registrar's Office to determine which office(s) are best suited to respond to your request.
You will receive a request acknowledgement and a follow-up email regarding the status of your request.

In general, data will be provided in aggregate. All requests will adhere to guidelines set forth by the Family Education Rights and Privacy Act (FERPA).

First Name

Last Name

Email Address (required)

Telephone Number

Department

Employee Category:

Administrator

Faculty

Staff

Student

Other - Specify below

Is this request related to: (Check all that apply)

Achieving the Dream

Completion / Submission of External Survey

Accreditation

Grant Proposal

Assessment / Course / Program Review

Grant Accountability

Class Assignment

Other External Source

Consultation on research project or survey development

Other

Completion / Submission of External Report

If this request is related to the submission of an external report or survey, please provide the name of report or survey:

What questions are you trying to address?

Please describe in detail the data, research or service you are requesting (e.g., student enrollment, graduation / retention rates,
consultation on assessment, survey development):

For what time periods are you requesting data? Be specific by listing semester and year(s).

How will this information be used?

Anticipated frequency of this request:

One time only

Per term

Annually

Other - Specify below

The data is needed by: (Use MM/DD/YYYY format)

We will be sensitive to your need-by date, but please note that data compilation and analysis take time and requests must be added to the offices' regularly scheduled projects.