Campus Data Analytics Pilot Consent Form
Provide your information and consent to participate in the campus data analytics pilot project.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Campus Affiliation
*
Please Select
Student
Faculty
Staff
Other
Department or Program
*
Purpose of the Campus Data Analytics Pilot
Consent Statement
Please read and review the consent information below. By agreeing, you consent to the collection and analysis of campus-related data as part of this pilot project. Your participation is voluntary, and you may withdraw at any time. Data collected will be used solely for research and improvement of campus services. No sensitive personal or financial information will be collected. If you have questions, contact the project coordinator.
Do you consent to participate in the campus data analytics pilot and allow your campus-related data to be collected and used as described above?
*
Yes, I consent to participate.
No, I do not consent.
Date of Consent
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature (Please sign below to confirm your consent)
*
If you have any questions or comments, please enter them here:
Submit Consent
Submit Consent
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