Institutional Research Service Request

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Date Needed Date Needed / MM / DD YYYY
Name Name First Last
Job Title
Department
Phone Phone - ### - ### ####
Email
Type of Request

Type of Request Data Request Survey Request Other
Title of Request
Request Details

Please provide as many details as possible such as: term(s), year(s), program code, degree-seeking, first-time freshmen, full-time/part-time, etc.
How will the data be used?

How will the data be used? Federal/State Requirement Accreditation Program Planning Assessment Grant Application Other
Will these data be shared outside of OSUIT?

Will these data be shared outside of OSUIT? Yes No
If yes, please specify who the data will be shared with: