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Survey Request

Thank you for your interest in data from the Office of Institutional Effectiveness, Research, Planning, and Grants.

A survey request is the collection of information or data from a sample of individuals through their responses or questions. Survey requests are prioritized according to institutional need, and certain survey requests may require additional approval.

Due to increasing survey fatigue on campus, IERPG must approve all surveys sampling the Cerritos College student population. IERPG will not administer more than one survey to the same population at any given time. Students should never be asked to complete more than one survey at a time. In semesters with high numbers of surveys (i.e., Spring), IERPG may restrict the number of surveys sampling the Cerritos College student population.

Faculty and external requestors wishing to conduct surveys for academic research (i.e., sabbatical projects, dissertations) must apply for Cerritos College IRB approval. External requestors must provide proof of IRB approval from their home institution.

Our timeframe for responding to survey requests can vary depending on workload within our office. To ensure that we can meet your desired timeline, please submit your request at least four to six weeks prior to your desired launch date. It may be necessary to meet with you if your project requires substantial resources.

Please note that requests are considered incomplete if there are any blank fields or required supporting documentation is missing. Incomplete requests will not be processed.

Requestor Information

Have you obtained approval for this request from your Dean or Manager? * 
 
 

SURVEY INFORMATION

Survey Type and Use

Select the reason that best describes the purpose of this request. Select all that apply * 
 
 
 
 
 
 
 
 

 

This survey is a(n): *   

If an old survey, please provide name of survey and research analyst that helped you with the previous request. If a project number was given to you, please include that as well.





How will survey data/results be used externally? Mark all that apply *
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Survey Sample & Distribution

Determining Sample *
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How often will this survey need to be administered? *
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Survey Administration: *
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Survey Administration Timeline

 

If your project does NOT have a due date, your assigned analyst will work with you to determine the completion date based on the complexity of your request.

 

 

Survey Instrument

If your survey contains any portion of a questionnaire that has been copyrighted or is the intellectual property of another party, have you received approval for use? *
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Survey Instrument: *
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Compliance and Acknowledgement of Understanding

By checking this box, I acknowledge that the data I am requesting from the IERPG Division may be denied, approved, cancelled, or prolonged.

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Data provided by IERPG must be used for Cerritos College purposes. Personal use of data are prohibited. The data that may be provided is to be used only for the purposes stated on the request form and approved by IERPG. Data provided may not be used for any other purposes or redistributed without prior written approval from the IERPG Division.

IERPG does not provide any raw data files to protect confidentiality and privacy, and to adhere to FERPA guidelines. Individuals/departments requesting data are expected to take measures to safeguard data. This includes securely storing data and safely disposing data. If provided data and/or a report by IERPG, do you agree that the data you are requesting will be:

  1. used for college purposes only,
  2. securely stored/safely disposed, and
  3. guarded against unauthorized alteration or inappropriate usage in accordance with college policies, and federal and state laws

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Supplemental Documents: If you have supporting documents for your request (grant report requirements, unit planning documents, student list, etc.) please send an email to research@cerritos.edu with the attached documents.

  • Study Information Sheet
  • Survey Consent Form
  • Survey Introduction
  • Survey incentive language
  • Survey Instrument
  • Invitation email text
  • Reminder email text
  • Last reminder email text

If your supplemental documents include identifying student information, FERPA regulations require files be password protected anytime such information is shared via email. Passwords should be emailed separately from the files. While emailing FERPA-protected data is permissible under the law, the Department of Education has ruled that an institution will be held responsible for a violation if any unauthorized individual sees the protected data via your electronic transmission.

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Please Note: Please note that requests are considered incomplete if there are any blank fields or required supporting documentation is missing. Incomplete requests will not be processed.

Our timeframe for responding to data requests can vary depending on workload within our office. We strive to provide requestors a received email with a status of your request within 5 business days of receipt.

Your request will not be considered complete until supplemental documents have been received.

*Required Fields

 

 

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