Page 1 of 2
Updated 2/19/2019
Statistical Analysis Center (SAC)
Presentation Request Form
Please complete all sections of the Presentation Request Form and submit to
staff will contact you by phone or email within five business days to verify data availability and timelines for
Date Submitted:
Your Name:
Your Title:
Agency/Organization Name:
Phone: E-mail:
Presentation Date:
(if applicable)
Slides Required by Date:
(if prior to presentation date)
Reason for Request (Please describe the purpose of this presentation and the intended audience):
Would you like a PDF version of the PowerPoint to disseminate to attendees?
Date PDF is needed:
(if applicable)
Page 2 of 2
Updated 2/19/2019
Type of Presentation:
Standard Request (most recent year of AYS data presented, unless otherwise noted)
Includes: 30 day substance use, most common substances used over time (last 3 iterations of AYS), binge/polysubstance
use, tobacco use (electronic cigarettes, traditional cigarettes), impaired driving, select risky behaviors, sources of
substances, perceived risk of substances, reasons for using/not using substances
Custom Request
Please describe what information you are looking for in your custom request:
Geographic Level(s) Needed:
ZIP code
Names of Geographic Level(s) Needed
If multiple zip codes are listed, would you like the data run for each individual zip code or for an aggregate
of these zip codes?
Individual zip codes
Aggregate of zip codes
Additional Requests
We look forward to working with you to meet your data needs. If you have preferences on how specific
survey questions are presented (e.g. specific variables presented by users vs. non-users, years included,
demographics), please describe your preferences below: