Student Affairs Data Request Form

All requests are subject to review and approval at the discretion of the Office of Student Affairs. Please allow five business days for your request to be processed. Actual processing time will vary depending upon the complexity of the request. Same day requests will require a consultation with Admissions and Student Services.
*Fields marked with a red asterisk are required.

Requestor First Name*

Requestor Last Name*

Requestor Title*

University Status*

Department/Organization*

Other Department/Organization

Email*

Phone Number*

Data Request Title*

Date Required By* (Please allow five business days for your request to be processed.)

How often will you need this information?*

Please select the population(s) for which you are requesting data.*

Year(s) Requested*

Please provide a detailed description of the information needed, including specific data fields. For results desired in Excel format, please list fields in the preferred order. *

Please provide a detailed explanation for the purpose of your request and how the information provided will be used. *

Please indicate the format for your desired results.

Will you distribute the results to affiliates external to Emory?*

Emory University Data Policy Statement

Please note the following regarding data requests. The RSPH Office of Admission and Student Services complies with Emory University’s Data Management Policy and the Family Educational Rights and Privacy Act (FERPA) for all student-related data.

Please read the following statement regarding student data before submitting your request:

Student data is protected by FERPA. Under this Act, individuals with an educational need to know may access student data for the purpose of fulfilling required job responsibilities. FERPA requires that you maintain the confidentiality of all students’ records, and that no information from the records be released to a third party without the written permission of the student.

I understand that the student data is being provided solely for the purpose described and may not be released to any third party not specifically listed on this request. I understand that if the student data is needed for another purpose, I must contact the University Registrar for authorization. I further understand that it is my responsibility to ensure that any systems/machines on which these student data are stored are secured according to Emory University guidelines. Finally, I understand that failure to adhere to this agreement may lead to loss of student data privileges or employee disciplinary action.

By submitting this form, you are accepting responsibility for maintaining the confidentiality of the information within this data request.