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Data Request Form
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Name
*
Your answer
Department
Your answer
Email
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Phone
Your answer
Description of Information Needed
*
Please provide as much detail as possible.
Your answer
Purpose of Request
(e.g. program review, state or national reporting, peer comparisons, grant requirements, etc.)
Your answer
Term(s) and Year(s) Needed
(e.g. Fall 2003, Spring 2004 - Spring 2006)
Your answer
Data Variables to Include
Please check all that apply.
Academic Program
Admit Term
Admit Type
Catalog Number
Class Section
Course Description
Credential
Degree
Employee ID
Gender
GPA (cumulative)
GPA (term)
Instructional Mode
Race/Ethnicity
Status
Student Email
Student Enrollment Status
Student Phone
Other:
Date Information is Needed
Your answer
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