Analysis Request Form

Name

First Name

Last Name

Phone Number:

(###)

###

####

Affiliation:

For example, the name of your community, school, business, organization, volunteer community group, government, department, etc.

Project Title:

This doesn't have to be final and it doesn't have to be catchy.

Project Summary:

This can be a research abstract, for example, or guided by the following questions: What’s the purpose of your research? What data are you interested in? What questions are you trying to answer? How will you share results?

Analysis Summary

If you're clear on the information and statistics you want explored, this is the place to describe them. If not, let us know what you're interested in more generally and we'll build an analysis plan together.

Partners and team members:

If you're working on this with a group of people, you can name them here.

Outputs and Outcomes:

What will be created as a result of this further analysis (e.g., reports, social media graphics, art, and more)? What will be made possible as a result of this analysis (e.g., greater understanding, decision-making, policies, programs)?

Analysis Request Form

1525 Birmingham Street, Halifax, NS, Canada, B3J 0B5