Project Request Form
Date: __________________________
Department/Office:
Requester: Phone:
Dean/Manager Signature:
Name of Project:
Purpose of Project:
Time Expected:
FOR OFFICE USE ONLY
TYPE AREA PURPOSE
__ Planning/ Exploratory Research __ Instructional __ POLICY Design/Development
__ Program Evaluation __ Student Services __ PROGRAM Design/Development
Review
__ Other:_________________ __ Other:____________ __ Other:___________________
Reviewed and Approved by Planning and Research Committee: _____________________________
Time Frame of Project: _______________________________
Form revised April 2001
Office of Institutional Research
Los Medanos College
01/01/2001
01/01/2001
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