RESEARCH REQUEST FORM




College of San Mateo's

Office of Planning, Research, & Institutional Effectiveness (PRIE)

Request for Assistance

(The time it will take to meet your request will depend on available resources. Generally, please allow 15 days or more lead time between approval date of your request and your date needed.)

Please complete the following information (below). Should you have questions, please contact:

John Sewart, Dean of Planning, Research, & Institutional Effectiveness

(650)574-6196

sewart@smccd.edu

or

Milla McConnell-Tuite, Coordinator of Planning

(650) 574-6699

mcconnell@smccd.edu



1. Type of assistance needed


Please check all that apply:

Data/information about CSM (e.g. students and programs)  
Data/inforation about the external environment  
Assistance with surveys or focus groups  
Consultation about research design  
Consultation or assistance with planning and workplan development  
Need for training or workshop  
Assistance with mass email to students or other targeted audiences  
Assistance with design of forms to capture data  
Assistance with external grants development  

2. Requestor Information

Name:


Faculty  
Staff  
Administrator  
Member of the community  

Division/Department

Phone

Email

Date of this request [mm/dd/yyyy]

Date information is needed [mm/dd/yyyy]


3. Project Title




4. What is the goal and purpose of this request?




5. Please describe your request in detail, including, time frame, etc.




6. The information is needed to meet the requirements for the following type of project:


(Check all that apply and please specify)

State/Federal Mandate  
Program Review  
Institutional Planning  
Accreditation  
Grant Proposal  
District Project  
College or Departmental Project  
Individual Faculty/Staff Project  
Enrollment Management  
Student Outreach  
Public Relations  


Please specify here.


7. For projects related to institutional research please specify the type of information requested:


Degree/Certificates  
Demographics  
Headcount/Enrollments  
Tracking Student Outcomes  
Placement Testing  
Program Review  
Matriculation  
Student Learning Outcomes  
Surveys (Qualitative data)  
Transfer  
Retention and Measures of Student Success  
Institutional Accreditation  
Grants  
Districtwide Data  
Assessing Program, Division, Department, or Institutional Effectiveness  
Assessing Program, Division, Department, or Institutional Productivity and Efficiency  
Focus Groups (Qualitative data)  

8. Will the project become a recurring one?


Yes
No
Not sure


(If Yes, how often and when does it need to be scheduled?)

RESEARCH OFFICE USE ONLY
  • Date Received:
  • Date Entered Into Project Management:
  • Data Sources:
  • File Name/Location:
  • Estimated Research Hours:
  • Estimated Staff Hours:
  • Estimated Computing Services Hours:
  • Estimated Completion Date:
  • Consultation with VP's, President, or President's Cabinet:
  • Assessment of Priority of Project:
  • Critical
  • High
  • Medium
  • Low
  • Actual Completion Date:
  • Project Number:
  • NOTES:

    •