Ad Hoc Data Request Form

When to use this form

Use this form when you are requesting data for a one-time use.

Requester

As requester, you guarantee that the data will be used only for the purpose requested.
You are responsible for destroying or deleting the data immediately after that use.
Staff or Faculty Name: / Email address:
College or Department: / Phone:
Club, if this request is in support of a club:

Purpose Helps analyze data availability and timing

How will you use the information you are requesting?
Today's date: / Desired date (anticipate two weeks for filling most requests):
Did we previously fill a similar request?
Yes. Include that Program or Query name, if known:
No

Data Selection Criteria What population are you trying to identify?

Students Other:

Student Enrollment Status

Currently enrolled
Eligible to enroll
Enrolled for classes next quarter
Graduating, quarter(s):
Admitted, quarter(s):
Accommodated, quarter(s):
Applicant for admission, quarter(s):
Other:

Student Degree Level

All Undergraduate Graduate

Student Major or College

All Major: College:

Special Student Selections

Include students who have chosen FERPA privacy, for the following academically justified reason:
Include deceased students. Reason:
Exclude faculty/staff enrolled on fee-waiver (applies only to current enrollment)
Exclude off-campus students (e.g. International or Exchange Programs, applies only to current enrollment)
Exclude on-leave students (e.g. on official/approved leave, applies only to current enrollment)

Other Selection Criteria:

Contents What information do you want about the above population?

Address

Mailing (Local)
Home(Permanent)
University (Dorm)
Header field?
(e.g., "To the Parents of "): / Email
Requestors of email addresses mustfollow the policy at
Other information:
Should the information be sorted (e.g., by last name, zip code, other)?

Media and Delivery How do you want the information returned?

Media

File in .CSV format (comma separated fields, Excel readable and usable by mail services)
Brio query that you can run yourself (you must have access to Brio and permission for the data)
Delivery
Email me Phone me for pick-up Other:

Comments or Special Instructions

Anything else that may help us process your request:

How to Submit this Form

ITS—Ad Hoc Data Request Form.docrevised: 10/25/06

Questions: Email

Ad Hoc Data Request Form

Save your completed form. Email it as an attachment to
  • if you are requesting information about students
  • for all other requests

ITS—Ad Hoc Data Request Form.docrevised: 10/25/06

Questions: Email

Ad Hoc Data Request Form

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ITS—Ad Hoc Data Request Form.doc4/20/2006

Questions: Email

Ad Hoc Data Request Form

Office Use Only

Query name: / Completed by: / Date:
Notes, Query Specifications, Comments:

ITS—Ad Hoc Data Request Form.doc4/20/2006

Questions: Email