Interest Form

Thank you for your interest in working with the St. Cloud State University Survey. Providing us answers as detailed as possible for the following questions will allow us to assess adequately our ability to assist you in your research and respond to your request in a prompt manner.

Contact Information

*Name:
Title:
Institution:
Address:
City: State: Zip Code:
*Email:
Phone:
Fax:

Contact Person:
Contact Phone Number:
Contact Email:

Survey Information

Please briefly describe your research topic and/or potential questions.

What are the approximate dates of data collection you prefer for your survey?

What number of completed interviews is your target?

What is the population from which you wish to draw your sample of potential respondents?

What length do you expect your questionnaire to be?
Pages
Minutes
Questions, of which are open-ended requiring coding

In addition to data collection, what services would you expect the SCSU Survey to provide?
Questionnaire design consultation
Coding of open-end questions
Data analysis and report writing
Other

Who will provide funding for the study?

On what date do you expect to submit a funding proposal for this project AND on what date do you expect a funding decision to be final?

Is there anything else we should know about your study at this point?

Untitled Document