Submit requests for surveys using the request form below. If you have attachments as part of your request, please send these attachments to Barbara Ping (email@example.com). Contact Information Requestor * Phone E-mail Division - None -Academic AffairsAdministrative ServicesOccupational EdPresident's OfficeSkill CenterStudent Affairs Department Name Date Needed Date Needed Year Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Purpose of the Survey - None -Academic AssessmentDissertationDistrict RequestEnrollment Management/MarketingGrantsHLCNew Program DevelopmentProgram/Service ImprovementSchedulingState/Federal ReportingStudent Success & RetentionOther Other Purpose Briefly describe the survey being requested. What level of analysis is needed? What level of analysis is needed? Raw data only Frequencies and descriptive data, no narrative Frequencies and descriptive data w/narrative summary Full study report w/data tables and narrative Other Other When are the analysis results needed? How will the survey results be used and what is the MEASURABLE outcome or benefit to the College? Will the survey audience include: (Mark all that apply) Will the survey audience include: (Mark all that apply) Students Faculty Staff Employers Community Members Other Other Audience Format Needed - None -On-linePaper Format (Scannable) IKON copy code How many surveys will be distributed? (approximate) Is this a new survey or an update on an existing survey? - None -NewUpddate for an existing survey Please attach the survey (.doc) or a list of questions to be included on the survey. Please attach the updated survey (doc.) or the survey title and a list of changes to be made to the survey.