Research Request Form
Allan Hancock College
Office of Institutional Effectiveness
First Name
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Last Name
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Phone # or extension:
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Email:
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Department:
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Dean/Manager/Supervisor Name (If you are this person enter 'self')
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Dean/Manager/Supervisor Email
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Have you discussed this research request with your Dean/Manager/Supervisor?
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By checking this box, I acknowledge that the data I am requesting from Institutional Effectiveness may be routed to the appropriate manager in my area.
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Type of research needed (check all that apply)
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Purpose of project (check all that apply)
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Describe your project: What question(s) are you trying to answer? Please be as specific as possible so that Institutional Effectiveness can best provide appropriate data (e.g., how many students successfully complete XXXX course in X term (disaggregated by gender, ethnicity, and age)?).
Your answer
The following selections should be reflected in the project description above so that the researcher can better understand the data you are requesting and how you would like it reported. Please respond only to items below that are relevant to your request.
Please include data from the following terms (check all that apply):
Please include data from the following academic years (check all that apply)
For what group or groups of students are you requesting information?
Select demographic categories you wish to include in your report (check all the apply)
Is there a specific course(s) or program(s) you are interested in?
Your answer
What course information are you interested in? (check all that apply)
What type(s) of academic progress are you interested in?
What type(s) of academic outcomes are you interested in? (check all that apply)
Format of data/information requested (check all the apply)
Desired delivery date of data/information (please allow 7-10 working days to process requests).
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DD
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YYYY
Please indicate if the project supports the following college goals, plans, or initiatives (check all that apply).
If you checked any of the above projects, please specify how your activity supports the project. Please be as specific as possible (e.g., Student Equity Plan Goad B)
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Please provide detail to any question you answered 'Other' to and/or provide any further information about your request.
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Has Institutional Effectiveness provided similar data/reports to you previously?
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