Request to Conduct Survey on Stanford Students

Instructions

Data from the University’s student information system is regarded as an institutional resource. Access to student data, including names, email addresses, biographic and demographic data, and academic information must support the academic mission and the operational needs of the University.

Complete all the information requested below. Attach a copy of the survey to this request. Requests must be submitted to the Registrar’s Office by the dates listed below. Requests submitted after those dates will be reviewed at the next applicable date. You will be informed of the Survey Coordinating Committee’s decision approximately three weeks after the submission of the request. IRB approval may be required for surveys of students. Whenever possible, results of the surveys should be made available to the Committee.

Requestor Information

*Requestor Name:	Required Value
*Requestor Email:	Required ValueA Valid Email Address is Required
*Confirm Email:	Required ValueThe Values Do Not Match
Office:
*Phone Number:	Required ValueUse (555) 555-1234 Format

 

Survey Information

Survey Name:	Required Value
Submission Type:	New Please make a selection Renewal Re-submission
Survey Type:	Web Please make a selection Mail Interview Other (explain): Please describe type.
Survey Frequency:	One-time Please make a selection Annually Quarterly Other (explain): Please explain.
Sample Size:	Required Value
Proposed Survey Dates:	Required Value
Data necessary from Registrar’s Office to conduct survey :	Required Value (e.g., name, ID number, birth date, gender, class, ethnicity)
Format of Requested Data:	Required Value
Explain the Survey Purpose:	Required Value
What do you hope to learn from this survey? Why would this survey be important to understanding students at Stanford? How would it contribute to understanding student issues or behavior? How would the survey support the business operation of the University by aiding the development of policy regarding students?
External Relationship:	Required Value
If this survey is part of a larger survey being conducted by another university or professional organization, describe your relationship to that university or organization.
Survey Results Recipients:	Required Value (explain to whom the results of the survey will be distributed)
Distribution Format:	Required Value (in what format will the survey be distributed?)
FERPA Compliance:	Required Value
Student information is protected under the Federal Family Rights and Privacy Act (1974) and by University policy. What steps will you take to insure that you are in compliance with your obligations under FERPA?
Upload Survey File:	File Upload Required