Data Request Form

Please allow – at a minimum – 10 (ten) business days to provide you with the data you are requesting

Please complete the following form to initiate your data request for the Department of Institutional Effectiveness. If you have any questions, please contact Stephanie Dykes, Ph.D. – Executive Director of Institutional Effectiveness at stephanie.dykes@seattlecolleges.edu.

Question Title

* 1. Please provide your contact information:

Name *

Department

Division, i.e. Administrative Services, Instruction, President's Office, Student Services

Email Address *

Phone Number

Question Title

* 2. Description of Request: Please include as much detail as possible about the population of interest (e.g., students enrolled in a range of quarters) and the specific data want to receive about that population (e.g., counts of students disaggregated by race/ethnicity, or a list of student names and emails for outreach)

Question Title

* 3. How will this information be used? Please use the space provided to describe how you plan to use this information.

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* 4. Data Request Frequency: Which of the following best describes the frequency with which you will need this data?

This is a one – time data request; I will only need this data once for a specific purpose. I do not anticipate needing to make this data request again.

This is a recurring data request; I will need this information on a regular, on – going basis.

Question Title

* 5. Requested Delivery Date: When would you like the data delivered by?

Please allow a minimum of 10 business days.

Date