Today's Date

Your Name

Your Email

Department/Program

Supervisor's/Manager's Name

  
1. All research requests require prior approval from area supervisor. Has your supervisor approved this research request?

Yes

No

2. What type of project is this request for?

State or federal reporting

Grant proposal or reporting

Program review

Accreditation

Shared governance, advisory, or committee group

Program, course, or department-level project

Student Learning Outcome (SLO)

Student Services Learning Outcome (SSLO)

Administrative Unit Outcome (AUO)

Other

3. This request is fulfilling which phase of your inquiry?

Discovery   I am gathering information to better understand my program/process

Planning | Designing | Redesigning   I am designing my program/process and would like the research to inform this development

Implementation   I have implemented a program/process and would like to know how it is doing

Evaluation   The program/process has been in place for some time and I want to identify gaps and areas to improve

4. What do you need help with?

I need to gather and/or analyze data

I need to develop a questionnaire for a survey or focus group

I need a student list for outreach or recruitment

I need training to use an online tool or database

Other

5. What is your research question(s)? What would you like to know? 
Ex: My students pass my class (or courses in learning community), but are they graduating? How long does it take them to graduate?

6. What are the parameters? What information is needed to help answer the research question?
Consider the following factors:
- The time period being assessed (e.g. fall 2013 to spring 2016)
- The student characteristics (e.g. gender, ethnicity, first time college/returning student)
- The desired outcome (e.g. retention, persistence, graduation, degree, transfer)
- If any course needs to be tracked, specify the term, course name, course number, and CRN

7. How often do you anticipate this request will need to be fulfilled?

One time only

Each term

Annually

Other