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Survey Request Form

Please complete and submit this form to request a web-based survey creation account. Attach a copy of the survey to be implemented and any associated materials that are available (letter soliciting participation, etc.). IRB approval, if necessary, should be obtained before the account is requested. When approved, COBTech will contact you with account details. Contact Beth Towell, Associated Dean for Undergraduate Academic Affairs, at 753-1246 with questions.