Name:* First Last Email:* Enter Email Confirm Email Title:* Department:* Describe Your Data Request:*Will the data you are requesting involve research? (Research means a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge).* Yes No How will this information be used? (please include any current or potential grant funding information)*Do you currently have Burrell College IRB approval?* Yes No Please provide your IRB status (pending, received from another institution, etc.).* Data Needed By:* MM slash DD slash YYYY Δ