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Request for Information Form

Information for Admission to the College Conducting Research at Pellissippi State

The Request for Information Form has been designed to facilitate the management of data and to anticipate information needs. Persons within Pellissippi State seeking data or information about the College are requested to complete this online form in detail and to SUBMIT it to the Institutional Research office for processing.

Items marked with an asterisk (*) are required.

1. Contact Name and/or Name of Person Originating the Request

 Name*: 
Title*:
Department/Unit*:
E-Mail Address*: 
Phone Number*: 

2. Describe Your Request:

Information requested*:
How is this information to be used? :
Has Institutional Research provided this or similar information to you in the past?
Yes
No
If yes, please describe :

3. Connect Planning To Goals

 Please identify the goal or goals related to this request. Goals can be viewed on the Institutional Research web site under College Initiatives.

Performance Funding
 General Education Goals

 Strategic Planning

Department goal(s): Explain how request relates to goal(s) or standard(s) chosen above.
Individual goal(s): Explain how request relates to goal(s) or standard(s) chosen above.
Today's Date*:
Date Needed*:

4. Submit Your Request:

Thank you for your request.

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Updated: 10-30-09 (SML)
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Knoxville, Tennessee 37933-0990 - Email: jhheuer@pstcc.edu - Phone: 865-694-6526