All data requests are approved by the Director of Planning and Research, Dr. Michael Cobb.  Persons outside of Brunswick Community College may require IRB approval.

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* 1. Name of Requestor

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* 2. Which best describes your role? (persons and entities outside the College may require IRB approval)

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* 3. Department/Organization/Business

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* 4. Job Title

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* 5. Email Address

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* 6. Phone (in case there are questions)

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* 7. Date Needed

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* 8. What is the data is related to? (check all that apply)

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* 9. Describe the data request in detail, and indicate what the data will be used for.

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* 10. What should the data include? (please be very specific - data points, range, etc.)

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* 11. Please indicate in what format you would like the data. (check all that apply)

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* 12. If you have a sample, please upload it here.

DOCX, DOC, JPEG, GIF, JPG, PDF file types only.
Choose File

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* 13. Is there anything else that we need to know about the request?

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