DAPPIC Short Survey Request Form

DAPPIC Short Survey Request Form
Welcome to the DAPPIC Short Survey Request Form. You can use this form to request survey and report links to administer in your courses. More detailed instructions including the contents of the surveys and sample reports can be found in the shared Google Drive folder for DAPPIC Short Surveys.
Please select the reason why you are completing this form

Request new survey and report linksI lost my survey and report links

Your details
Name*

First NameLast Name
Email*
example@example.com
Please select your institution*
Please enter the name of your institution here
Please select your academic unit (e.g., department OR school / college if department is not applicable).*
Please enter the name of your academic unit here

Survey Request Details
- Survey Type: Select which survey you would like to request
  - Two Week Survey: Distribute to students in a specific course and/or section at the end of the second week of the term in order to gather information to inform potential adjustments during the term.
  - Last Week Survey: Distribute to students in a specific course and/or section at the end of the term in order to identify impact of adjustments made after Two Week Survey and/or inform potential adjustments in future terms.
  - Drop/Withdraw Survey: Distribute to students who have dropped or withdrawn from a specific course and/or section to better understand motivation and inform potential adjustments in current and/or future terms.
- Course Type: Select the course you are going to be implementing the survey in (CS1, CS2, CS3)
- Course and Group Name: Enter the course name and group descriptor for each survey. This will be used to help you identify the survey instance in your report.
  - E.g., CS201 - Introduction to Computer Systems - Section 1
- Demographics: Select Yes/No depending on whether you would like demographics questions to be displayed to the students. Note that if you select "No", reports for that survey will not include demographic breakdowns and will only be able to display data for all students in the course.
- Contact Name and Email: Enter the name(s) and email address(es) of people who should be contacted for each survey. These individuals will receive an email for each survey requested containing the information they would need to distribute the survey and view reports. If you need to enter multiple names and/or email addresses, please separate with a comma.
More detailed instructions about the DAPPIC Short Surveys can be found here.

Please complete the following information for all the surveys you would like to request at this time. *

	Survey Type	Course Type	Course and Group Name	Demographics	Contact Name	Contact Email
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Please use the space below to share any questions or comments you may have regarding the DAPPIC Short Surveys.
If there are any of your colleagues you would like to recommend our surveys to, we would be happy to reach out to them. Please enter their contact information below. We will use this information only to send them a message regarding the DAPPIC short surveys.
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