Request for Data Form

Contact Information
Person Requesting Data
First Name:
Last Name:
Baylor Department:
Email Address:
Desired Completion Date:
Phone:
Fax:

Data Requested
Please describe the data that you need .
Specify any selection criteria, including which semester(s) and year(s) should be included, classification of students requested, etc. If data is needed for a specific form, please fax or email us a copy of the form.
Please state the purpose/use for the data.
Have you received THIS data from IRT in the past? Yes | No
If yes, when?
Are you sending us additional information?: No | FAX | Email
FAX 254-710-2062 Email Dr. Kathleen Morley