| First Name |
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| Last Name |
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| Work Phone |
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| Department |
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| Index Code |
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| Email |
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| Either select NOT HLC DATA or select the appropriate HLC Committee / Member from the list below: |
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| Due Date *Please allow at least (10) business days to complete. |
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| General scope of the project (Statement of Purpose) |
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| Research questions expected to be answered |
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| Design of project (research methodology documentation) |
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| Population to be studied |
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| Timing of research project |
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| UST resources / information required |
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| Security plan for storing information |
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