Institutional Survey Request Form

Members of the Nipissing University community (students, faculty and staff) who wish to conduct a survey of Nipissing University students, staff, faculty, applicants or alumni that asks for information about their use of, or experience with, Nipissing University facilities (includes physical facilities, programs, research, academics, personnel, management and environment, among others) are required to submit a proposal to the Survey Management Committee for approval in accordance with our Survey Management Policy.

Any person or group wishing to conduct a survey as described above should submit a request to the Survey Management Committee for permission to proceed. Proposals are to be submitted well in advance of the intended start date of the survey to allow ample time for review; a lead time of six weeks is recommended.

Survey Request
Objective(s)
Rationale
Subjects
What is the target population? (i.e. to whom should the survey be sent?)
Execution
Please note: a minimum six-week lead time is required.
Is this a recurring survey?
Data Management
Attachments
  • Any materials to be used in communicating with potential respondents (e.g., cover letters, e-mails, website splash page); and
  • Finalized survey instrument.
Maximum 10 files.
12 MB limit.
Allowed types: doc docx xls xlsx.