ECC Institutional Research
Work Request Form
Please be sure to read the guidelines if you have not previously done so.
Office Location: (Room #, Building)
Student and Community Advancement
Admissions & Records
Behavioral & Social Sciences
Health Sciences & Athletics
Industry & Technology
For standard requests, please allow 3 - 4 weeks for delivery.
DESCRIPTION OF REQUEST
Survey design and creation
We will be generating a report or survey in conjunction with your request and would like you to give us a short title. This will help us locate any reports or data associated with this request in the future.
Time Frame (specify terms, etc):
Describe your request. What question(s) are you trying to answer?
“If you are requesting a survey, indicate the number of copies needed.”
If your request is similar to work that was done previously, indicate for whom and the approximate date the work was done.
PURPOSE OF REQUEST
Main Purpose (select one that most closely matches the reason for your request):
Grant application or report
Other curriculum/program/service assessment
Prerequisite/corequisite/test validation study
State or federal reporting
Report to an outside agency
Student learning outcomes creation/assessment
Support for funding request
With whom will the data be shared?
How do you plan to use this information to improve the college?
Link To ECC Strategic Initiatives
ECC Strategic Initiatives related to this request (check all that apply):
Strategic Initiative A (Enhance teaching to support. . .
Strategic Initiative B (Strengthen quality educational and support services. . .)
Strategic Initiative C (Foster a positive learning environment. . .)
Strategic Initiative D (Develop and enhance partnerships. . .)
Strategic Initiative E (Improve processes, programs. . .)
Strategic Initiative F (Support facility and technology. . .)
Strategic Initiative G (Sustainability)