Bellevue College Survey Submission Form

Bellevue College Survey Submission Form

Survey Contact Information

Surveys submitted for review and registry must have a survey contact for the purposes of communication and to be associated with the survey on the survey registry and calendar. You can only distribute your survey after you receive formal approval via an email from Effectiveness & Research.

Name*

Email Address*

Program or Office*

Survey Registry Information

This section collects basic information that will be available in the survey registry or calendar. These are required for all surveys, including those that have been previously reviewed and approved.

Survey Name*

Survey Purpose*

When providing the survey's purpose for the survey registry, consider describing broadly what you are hoping to learn more about, what decisions you are seeking to inform, or what requirements the survey is satisfying (such as in the case of specialized accreditation).

Who are the target population for the survey*

Major populations at Bellevue College are students, faculty, and staff. Be specific if there you are looking to survey a subset of those major populations.

Will this survey be conducted anonymously or confidentially?*

For a survey to be conducted anonymously, no identifiable information can be collected in the survey or tied to the individuals' responses, ensuring that not even the individuals conducting the survey know who said what. For a survey to be conducted confidentially, only the individuals conducting the survey can know the identity of the respondents, and there is a commitment to never share identifiable information with others. If the identity of respondents is not going to be protected by anonymity or confidentiality, please select "neither anonymous or confidential."

Anonymous

Confidential

Neither Anonymous nor Confidential

When are you planning on having the survey launched?*

When do you plan on the survey closing?*

Survey Instrument

This is the version of the survey that you are submitting for review, including all questions, descriptive text, and the logic and overall structure of the survey. The survey instrument itself will be not be published on the survey registry or calendar,

Has this survey been previously reviewed and approved by Effectiveness and Research*

Surveys that were previously approved need only be submitted to be included in the survey calendar and registry, but do not need approval before being distributed. Please still supply a copy of the survey so that we can match it to the previous survey.

Yes

Please attach a copy of the survey, preferably in .docx format.*

In Qualtrics, under "Tools" you can select "Import/Export" and then "Export Survey to Word". If you have complex logic, we recommend checking the boxes to "Use Question Numbers" and "Show Survey Flow".

Drag and drop files here or

Supplemental Questions

These questions are helpful for understanding more about how surveys are being conducted, but are not required.

Are you also submitting this survey to the IRB as part of a human subjects research study?

Studies that meet the definition of human subjects research require Institutional Review Board (IRB) review. If your survey is to inform or evaluate practices and initiatives at the college, it likely does not require IRB review. If the survey is to contribute to generalizable knowledge outside of Bellevue College, then the study likely does require IRB review.

Select

About how many people do you plan to send the survey to?

Which survey tool are you using to distribute the survey?

If the tool you are using is not listed, you can write in the name of the tool yourself.

Select or enter value

What other comments or notes do you have about this request?

For example, if you have collaborators who may be able to better respond to particular questions about the request, please provide their name and contact information.

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