Request for Computer Output Form

**This request form is for campus use only. Lists will only be released to authorized University personnel.**

Procedures:

1. Complete this form and click "Submit" to transmit to the Office of Institutional Research (OIR). If you have questions concerning this form, please contact us at 701-777-4358.
2. This form is reviewed for:
   1. Completeness and clarity
   2. Appropriateness of data release

Note Limitations: Occasionally, requests are submitted for data which are not in the student data system (e.g., height and weight of all students who may be interested in playing rugby). Sometimes requests are submitted for data in formats which are not possible. With such requests, Requester will be notified of limitations.

1. If OIR has questions with your request, you may be contacted.

All fields are required to be filled in. Date Needed:     Requested By: Name   Email   Department   Phone Number 1. Service Requested:      Computer List/Report PDF    Excel 2. Request is:    One-time Only       Going to be needed again     If needed again, please enter schedule   3. Has this request been processed before?    No    Yes If yes, provide Report ID 4. Title of the Report: 5. Before completing item 5 click here for more information. Describe the output desired:. What data is needed, what are the selection criteria, in what sequence should data appear, and how data should be separated. (For example, supply a list of students majoring in journalism along with their permanent address and emails for spring term 2010 in alpha order, and titled JOURNALISM MAJORS.) The data system provides several choices for address, and major/minor, etc. Please be specific. IF necessary, type in a sample of the desired output.   6. Use and purpose of data: What student organization or UND office will use the data?   7. Is this data going to be used for a survey? No Yes   If yes, survey begin date end date   Used for Research?             No Yes   Note: All research with human participants conducted by faculty, staff, and students associated with the University of North Dakota, must be reviewed and approved as prescribed by the University's policies and procedures governing the use of human subjects. No activities are to be initiated without prior review and approval by the Institutional Review Board. The Office of Institutional Research will require a copy of the consent form from IRB. 8. If confidential information is provided, describe procedures you will implement to protect confidentiality.   I have taken FERPA training. No Yes     9. The requesting Administrator/Faculty must agree to the following: The requested information will be used for the above purposes only. As the UND administrator/faculty responsible for the organization or office outlined above, I recognize that any other use of this information violates the Family Educational Rights and Privacy Act (FERPA) and cannot be released further on or off campus. If provided with confidential information, I will expect to: Handle the information in a secure fashion to ensure it remains confidential Communicate the information only to other parties authorized to have access to it in accordance with the provisions of FERPA Use the information only for its intended purpose Properly dispose of the information when it is no longer needed   Requesting Administrator /Faculty Name  E-mail Address Phone Number

Additional information regarding data requests

 

1. All organizational/agency requests for student information must be limited to the information and the uses as described in Section 8 of the Code of Student Life.
2. The requesting agency must be a recognized University organization.
3. The request must include a specific statement as to the purpose for the request and how the information will be used.
4. Procedures as to how the confidentiality of information released will be assured must be stated by the requestor.
5. The information provided cannot be used for profit in any way and, therefore, cannot be used for solicitation purposes other than for:
   1. membership recruitment
   2. newsletters and/or other organizational promotional materials
6. Any cost associated with the recovery of the information will be borne by the requestor (e.g., labels, disk, CD).
7. You will be contacted if the IR Office has any questions or concerns about the feasibility or appropriateness of your request.