This form is used to request project assistance from the UCO Office of Assessment. If you need assistance please contact us at 974-3342.

1.	Date Submitted: (mm/dd/yyyy)

2.	Department Requesting Service:

3.	Type of Project
	--Click Here--SurveyTestConsultationOther

4.	If Other, please describe project:

5.	Estimated Cost of Project (if Known):

6.	Funding Source:
	--Click Here--Assessment course feesE&G accountUnknown

7.	Is this a new or continuing project:
	New		Continuing

8.	Please give a brief description of the project:

9.	Level of Project:
	College		Departmental

10.	Point of Contact:

11.	Phone number contact can be reached:

12.	Estimated Project Start Date (mm/dd/yyyy):

13.	Estimated Project Completion Date (mm/dd/yyyy)

14.	Reason for Project:
	Regional Accreditation		Course level Assessment
	Major level Assessment		Planning
	Program level Assessment		Specialized Accreditation

15.	Additional Comments or Requests:

If you have not been contacted by the Office of Assessment within 2 business days, please contact us at 974-3342.