Request for Information or Project

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Please complete the following form to request data, information or a project from the Office of Institutional Research.

All fields are required!

Use the tab key or your mouse to move between fields.
Using 'enter' will submit the form.

Project Title:
If the project needs to be completed by a specific time period, what is the month and date?:
Person Requesting Information
First Name:
Middle Initial:
Last Name:
NWACC Employee:	Yes No
Department/Division/Committee:
Phone:	In the format of: 555-555-5555
Email Address:
Project Description: (be very specific):	characters left
Please explain how you intend to use the information? For example, as a result of this activity, what will you have gained?	characters left

	This information is to be used outside the institution to complete such activities as graduate course requirements, agency research, or research for other institutions, therefore, I am submitting a completed FERPA Disclosure Agreement along with this request.
	I agree to follow all FERPA guidelines in receiving this request from the Office of Institutional Research.
	*Please certify that you are the individual completing this application by signing it. You may sign it by typing your initials in the box.
Please validate that you are not a spam bot 8 + 7 =

Please allow at least 10 working days to receive your data. A longer time period may be required because federal and state reporting deadlines will be given priority.

For questions/comments on this form, please contact Sean Lucero.

This page was last updated on: August 31, 2010 @ 11:58 am

NorthWest Arkansas Community College, One College Drive Bentonville, AR (479) 63-NWACC (479-636-9222).
We also have locations in Washington County and Bella Vista.
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