Office of the Registrar

Request for Computer Output

*	This request form is for campus use only. Lists will only be released to authorized University personnel.

Procedures:

Complete this form and press "Submit" to transmit to the Office of the Registrar. If you have questions concerning this form, please contact the Office of the Registrar at 701-777-2712.

This form is reviewed for:

a.	Completeness and clarity
b.	Appropriate approvals

Note on Limitations: Occasionally, requests are submitted for data which are not in the student date system (e.g., height and weight of all students who may be interested in playing rugby). Sometimes requests are submitted for data in formats which are not possible. Such requests will be returned to the Requester with appropriate notations.

Upon completion of the request, a copy of the original request will be attached to the output and the user will be notified.

* Required field
*Date Needed:

Requested By:

*Name

*Department

*Phone Number

Account No. for Labels

(Used to bill for labels-$10/thousand)

*Department Account No.

*Service Requested:

Labels Only

Labels and Computer List/Report

Computer List/Report

*Request is:

One-time Only

Going to be needed again*

*Please enter a schedule when you will need it

*Has this request been processed before?

Yes

If yes, Report ID

*Title of the Report:

Before completing item 5 click here for more information.
*Describe the output desired:. What data is needed, what are the selection criteria, in what sequence should data appear, and how data should be separated. (For example, supply a list of students majoring in journalism along with their permanent address and cumulative GPA, for spring term 1997 in alpha order by sex, with each sex on a separate page and titled JOURNALISM MAJORS MAILING/GPA LIST BY SEX.)

The data system provides several choices for address, GPA, and major/minor. Please be specific. Type in a sample of the desired output.

*Use and purpose of data: What student organization or UND administrative office will use the data? HOW WILL INFORMATION BE PROTECTED TO INSURE CONFIDENTIALITY OF INFORMATION?

Authorizing Administrator/ Faculty
	*Name

	*E-mail Address	*Phone Number

The Authorizing Administrator/Faculty will be contacted for approval and must agree to the following:

Administrative Authorization: The requested information will be used for the above purposes only. As the UND administrator/faculty responsible for the organization or office outlined in No. 5 above, I recognize that any other use of this information could be a violation of the University policy and Section 8 of the Code of Student Life. Further, I realize that such violation may result in loss of the privilege of obtaining further information.

Additional Information for Item 5

All organizational/agency requests for student information must be limited to the information and the uses as described in Section 8 of the Code of Student Life.

The requesting agency must be a recognized University organization.

The request must include a specific statement as to the purpose for the request and how the information will be used.

Procedures as to how the confidentiality of information released will be assured must be stated by the organization.

The information provided cannot be used for profit in any way and, therefore, cannot be used for solicitation purposes other than for:

a.	membership recruitment
b.	newsletters and/or other organizational promotional materials

Any cost associated with the recovery of the information will be borne by the requesting organization (e.g., labels, disk, CD).

The approving office is responsible in following up with requests to insure that the information requested is received by the organization/agency and that the use of the information is as agreed upon.

Click here to return to item 5.

University of North Dakota | Registrar's Office

Grand Forks, ND