To help expedite data requests, please complete the form and submit it for fast and friendly service. If you have questions, please contact: Office of Institutional Effectiveness Dominican University Parmer Hall 115 Email: oie@dom.edu Upon receipt of your request, an OIE staff member will contact you. At that time, a deadline date for receipt of the data will be negotiated based on the priority of the item, the complexity of the request, and the present workload of staff members. The form will ask you to describe how the requested data will be used. Please indicate the purpose for which the information is needed (e.g. budget planning, department operations, curriculum review, accreditation, assessment, grant proposal, etc. Also indicate if the information will appear in an internal or external report or document. You are encouraged to be as specific as possible in order to receive more useful information. Please note that in order for us to maintain data security and to protect the confidentiality of student, faculty and institutional information, we may not be able to accommodate your request. We will be in touch with you to review appropriate data use and access as the situation warrants. Name of Person Making the Request * Position Position * - Select -FacultyStaff/AdministratorStudentOther, please describeMaximum allowed: 250 characters Position Maximum allowed: 250 characters Department/organization Email Address * What type of data are you requesting? (e.g.,student, faculty, university, other) What terms (i.e., Fall 2017, etc.) would you like the data to reflect? Description and purpose of the data requested: Description of data requested: Date your data is needed: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20162017201820192020