Rio Hondo College - Survey Request Form

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Research Request Form

Survey Request Form

Survey Links

Factbook 2007

Please fill out the survey request form with as much information as possible. Be very specific as to your survey needs. The request will be forwarded to your Dean for approval and then a timeline for delivery will be sent back to you and any additional information needed to fill the request. If you have any questions, please call Jacqueline at x. 3134.

1. Briefly discuss the objective of the survey.

2. Who will be filling out the survey?

3. Do you need help identifying people to be surveyed?

4. Please list the selection criteria.

5. Do you have some sample questions that you would like to use in the survey? Please list them.

6. When do you want to deploy the survey?

7. How do want to deploy it? (Paper, scannable, online or more than one method)

8. Will you need help with the analysis of data after it is collected? If so, what you will need.

9. Any additional information.


Name:		Extension:
Department:		Dean: