DPI Confidential Data Application

First name

Last name

Phone number

Any phone number format will do, but include your area code like: 920-555-1212

Email address

Organization Name

Enter the name of the organization for the purpose of this application.

Organization Address

Enter the organization's address, city, state, zip code, and phone number.

Comment why public data available on the DPI website cannot be used

To help us determine and prioritize future public data offerings, tell us why public data (i.e. WISEdash Public Portal and downloadable spreadsheets) available on the DPI website cannot be used for this request.

DPI Contact Name

Enter the DPI contact name if you have been in contact or currently working with someone at DPI on this request.

Title of Research Project

Do you have IRB approval?

Yes

Exempt

Is the research approved by an Institutional Review Board (IRB) for purposes of human subjects study? After your application is submitted, DPI will be contacting you for supporting documentation to support your answer.

Desired Research Start Date

Projected Research End Date

Executive Summary (Abstract)

Describe the scope of the entire project in clear and non-technical language. Limit response to 250 words.

Primary Research Questions

Write the primary research questions as clearly and precisely as possible.

Research Benefit

How will your research benefit education in the state of Wisconsin?

Expected Products

List all the expected products from this research project. (i.e. journal article, book chapter, web tool, white paper, other output. . .)

Data Request Information

Describe the confidential data you are requesting in this application. Do not enter any Sensitive Personally Identifiable Information (SPII) in this section.

State

Yes

District

Yes

LEA (Local Education Agency)

Yes

School

Yes

Teacher/Class

Yes

Student

Yes

Select the data level of detail needed to support this request. (multiple selections are allowed)