Request to Obtain Membership Information for Research Assessment Purposes

Request to Obtain Membership Information for Research Assessment Purposes

All researchers must be ACPA Members
Contact Information
Full Name*

First/Given NameM.I.Last/Given Name
Title
Institution
Phone
Department
ACPA Membership Number*
Street Address
Fax Number
City, State, Zip/Postal Code/Country
E-mail*
Personal Information
FacultyStudent Affairs ProfessionalStudent *Other
Letter from Faculty Advisor (If Applicable):

Please upload a letter from your faculty advisor which includes their name, title, department institution, email, phone number, and signature below the following statement:

"I agree to supervise this student’s research or assessment project and I will assist this student in maintaining appropriate research ethics. I also understand the application review process may take 3-4 weeks to complete"
Faculty Letter

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Survey Requests

ACPA does not allow surveys to be sent to all members. Researchers are asked to focus their studies on a specific position level (entry, mid or senior) or primary job function (see ACPA membership form for a complete list).
Study Information

Please briefly describe the purpose of your study, including:
1) the connection of your study to ACPA’s organizational mission
2) the timeline for mailing and anticipated duration of your project; and
3) the expected outcome of your study (e.g., dissertation or thesis, publication, conference presentation).
(Attach additional sheets if necessary; not to exceed four double-spaced pages.)
Please submit a copy of your survey questions.

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Human Subjects Information
Please attach a copy of your institution’s Human Subjects or Institutional Review Board (IRB) approval for this study.

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If there are any risks associated with this study, please detail them in the space below.
Verification of Information

I certify that the above information is accurate to the best of my knowledge. I also acknowledge that I have read and agree to abide by the research ethics and non-discrimination statement outlined on the following Web page
Should be Empty:

Contact Information

Personal Information

Study Information

Human Subjects Information