New Mexico Higher Education Department Planning and Research Division
Data Request Form
Name of Requestor, Title/ Position within Organization, Organization information
address: Street, City, State, Zipcode, telephone, Fax, Email (no PO Box)
What is the intended use / purpose of this data?
(No further information required)
What is the report question?
What is the report title?
Are you linking this data to any other data set or sources? Please specify exactly.
Does the report require tracking of individual students? That is, will the data include fields that allow the individual to be identified by the investigator through a unique ID or set of identifiable fields such as name, school, DOB, or other information?
Type of data requested:
(Please provide as much detail as possible so that our office can help determine what data will fulfill your request. Contact our office prior to submission for best results)
Detailed description of data needed:
(i.e. student enrollment, admissions, degree, graduation / retention rates)
Display of data:
(i.e. by gender, ethnicity, department)
Who reviews this report? Please input name, title, and position within organization.
(Please list all review boards and provide contact information)
Is this report covered by any legal agreements outside of NMHED? If yes what agreement(s) and between whom?
Requested Delivery date: (Please allow a minimum of two weeks for completion) If needed sooner, please explain:
(i.e. data needed during legislative session)
Type of Request
Check here to accept NMHED polices and the following statement: The institution, agency or entity, including the individual, who is requesting student data in any form, from the New Mexico Department of Higher Education (the Department) hereby verifies all provisions of the Department’s Data Sharing Agreement will be strictly complied with in all aspects at all times.
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