Data/Service Request Form

Contact Information

1. Name:

2. Title:

3. Department:

4. Phone number:

5. Email:

6. Date needed:

6. Date needed:

- Select -Within two weeksWithin a monthNeed to discuss (explain below)

Enter other…

Data/Service Request Information

1. Type of request:

- Select -For use by an external agencyFor internal use by an ASU unit

2. Is statistical analysis required?

- Select -YesNo

3. If you answered yes to previous question, please describe the statistical analysis being requested:

4. Purpose

4. Purpose

- Select -Recruitment/MarketingProgram ImprovementPlanningExternal ComplianceResearchOther (specify below)

Enter other…

5. Description of Data/Service Requested (please provide a detailed description of the data requested, including any selection criteria, e.g. first-time freshmen, biology major, departments/colleges, etc.):

6. Point-In-Time Requested (OIR data is not real-time data; it is structured by point-in-time, e.g. term "Fall 2011," academic year 2011-12, or fiscal year 2011-12):

7. Returned File Format (data will be provided in Excel format, if not stated otherwise):

Submit