ARCHIVAL DEPOSIT
AUTHORIZATION FORM
Data and Information Services Center (DISC) at the University of Wisconsin-Madison has received the dataset entitled:
______
______.
As the official distributor of this dataset, DISC assumes responsibility for the condition of the files comprising this dataset as well as changes made to the data.
I hereby designate Data and Information Services Center at the University of Wisconsin-Madison as the official distributor of the above named dataset.
Signature ______Date ______
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Please indicate the provisions under which DISC may distribute this dataset.
___ 1.) Unrestricted access via the World Wide Web or external media, such as
CD-ROM, diskette, etc.
___ 2.) Unrestricted to persons at the University of Wisconsin-Madison only.
___ 3.) Access only with the permission of ______.
___ 4.) Other ______
DATA AND DOCUMENTATION INVENTORY
FOR ARCHIVED STUDIES
The following is a list of the documents needed to archive this dataset.
1. Descriptive title of study:
2. Principal investigator(s):
3. Abstract that includes description of study, content, research objectives, etc. If
contained in an article or book, attach or give citation.
4. Key-word descriptors:
5. Methodology report which includes the following:
a. Weights if used
b. Sampling error
c. Response rate
d. Coding error reports
6. Do the data contain non-numeric codes, such as blank, amp, dash, alphabetic
codes, etc.?
7. Type of file(s):
8. Geographic coverage:
9. When were the data collected?
10. Time span covered by the study:
11. Was the research supported by a grant? If yes, please supply name of agency or
organization and grant number.
12. List the publications resulting from the study (or supply bibliography):
13. Codebook and supporting documentation:
14. At least one copy of all questionnaires of interviews used. This should include
original language and English versions.
15. All instructions given to the interviewers and coding section.
16. How many distinctly different files (or samples) are included in the study?
17. For each data set (or sample), please state:
FILE NAME / WEIGHTED / UNWEIGHTED / # OF VARIABLES PER CASE OR RECORD / FIXED LENGTH / VARIABLE LENGTH / # OF CASES OR RECORDS / SIZE OF FILE______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
______/ ______/ ______/ ______/ ______/ ______/ ______/ ______
cs lc
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