Survey Research Committee - Survey Application

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Your Name*¨Please

Daytime phone*

Alternate phone*

Email Address*

Relationship to NSU:* Please Select Student Faculty Staff

If Student: Faculty Advisor and their contact information*limit to 750

Please provide a brief description of applicable professional, educational, employment, professional licensure, and research experience.*

Please indicate the desired population to be surveyed.*

What is the intended method of survey design, administration and data analysis?*

Please provide the rationale for the sample size.*

What is the proposed date on which the survey will be administered and any dates for pre- or post- mailings encouraging survey participation?*

Are there any planned incentive programs for the respondents? If yes, please provided detailed information.*

What is the purpose of this survey and how will the information collected be used?*

What is the strategic or research context of the survey?*

How will the data from the survey be stored?*

How will the results of this survey be communicated?*

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