Data Requests submitted on this form are reviewed by the Director of Institutional Effectiveness and Strategic Initiatives.

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* 1. First and Last Name of Requestor

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* 2. Which best describes your role? Note: Persons and entities outside of Brunswick Community College may require IRB approval)

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* 3. Department at Brunswick Community College/Organization or Business Name

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* 4. Job Title

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* 5. Email Address

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* 6. Phone Number

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* 7. Date Needed (Please allow at least two weeks from the request date for data research and analysis.)

Date

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* 8. To what area does the data pertain? Select all that apply.

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* 9. Please select the specific terms from which you need data. Select all that apply.

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* 10. In specific detail, describe the data that you need.

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* 11. What are the specific data points being requested (range, etc)?

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* 12. What is the intended use of this data?

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* 13. In what format would you like to receive the data?

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* 14. If you have a sample of your data request, upload it here.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 15. If there is additional information that we need to know about this data request, enter it below.

T