New Mexico Higher Education Department Planning and Research Division
Application for MOU
Name of Individual / Agency / Organization applying for MOU
Physical address were work and storing of data will take place (if multiple locations put all down)
Building #, Street Name, City, State, Zip (P.O. Box not allowed)
Purpose of MOU
Name of Project, Expected Results of Project
How will the Individual / Agency / Organization applying for MOU benifit from this agreement?
How will NMHED or the State of New Mexico benefit from this MOU?
State specific plans for protecting the confidentiality and use of the data.
Number of person(s) who will have access to the data?
List: Names, Titles, Positions, and Phones #: 555-555-5555
Other information that the Individual / Agency / Organization deems important for NMHED to Know?
Is there an IR Board? More information the better!
The individual / Agency / Organization acknowledges and accepts NMHED policies and term for this MOU Application
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