Official Seal of the California Department of Education

Form

Data Request Intake

Analysis, Measurement, and Accountability Reporting Division

Individuals or institutions with data-related inquiries or requests that cannot be fulfilled using publicly available data resources and who meet the specified criteria to be considered an “authorized representative” may submit a data request using this Data Request Intake Form.

Instructions: Please complete the following fields in order to formally request data from the California Department of Education (CDE). All fields are required to be completed, unless otherwise noted.

If you have any questions about this form, please email cdedatarequests@cde.ca.gov.

	Researcher Information
	Principal Researcher First Name:
	Principal Researcher Last Name:
	Institution Name:
	Principal Researcher Phone Number: (999-999-9999)
	Principal Researcher Email Address:
	Proposed Research Project Title:

Other degree obtained, please specify:

	Attach the concept paper: (File size limit is 20MB)

	Attach the professional curriculum vitae (CV) of the Principal Researcher: (File size limit is 20MB)

How many scholarly publications has the Principal Researcher published (i.e., peer-reviewed journal articles, book chapters) focused on education research?

Zero

One to two

Three or more

	Please list the name, date, and publication for each article:
	Article 1 Name:
	Article 1 Date:
	Article 1 Publication:
	Article 2 Name: (if applicable)
	Article 2 Date: (if applicable)
	Article 2 Publication: (if applicable)

	Please list the name, date, and publication for your top three articles:
	Article 1 Name:
	Article 1 Date:
	Article 1 Publication:
	Article 2 Name:
	Article 2 Date:
	Article 2 Publication:
	Article 3 Name:
	Article 3 Date:
	Article 3 Publication:

	If the Principal Researcher is a graduate student working under the supervision of a faculty member, please provide the CV for the faculty member: (If applicable; File size limit is 20MB)

Has anyone on your team ever worked with student-level or other sensitive, personally identifiable data?

Yes

The organization you work with is which of the following?

Non-Profit Research Group

For Profit Research Group

Unaffiliated Research Group

Local, State, or Federal Government Agency

University/Higher Learning Entity

K-12 Education Agency

Other

	Other organization, please specify:

Does your organization have in-house legal counsel with expertise in privacy laws, including the Family Educational Rights and Privacy Act (FERPA)?

Yes

	Legal Counsel Information
	Legal Counsel First Name:
	Legal Counsel Last Name:
	Legal Counsel Phone Number (999-999-9999):
	Legal Counsel Email Address:

This request is primarily to perform the following:

Research Study

Audit or Evaluation of an Educational Program

Other

	Other research request, please specify:

This study best aligns with which of the following CDE Research Priorities? (Select all that apply)

Equity

Culture, Climate, Family Engagement

Educator Quality and Retention

School Finance

Implementation of the California State Standards

Cradle to Career

COVID-19 Impact

Other

	Other CDE research priorities, please specifiy:

This proposal is an original research study that does not replicate findings from other research published in the past five years:

Yes

List of Available Data Elements: (Select all that apply)

California Assessment of Student Performance and Progress (CAASPP)

English Language Proficiency Assessments for California (ELPAC)

Physical Fitness Test (PFT)

California Longitudinal Pupil Achievement Data System (CALPADS)

Other Data Element

	Other Data Element, please specify:

	Number of School Years Requested: (Separate years requested with commas, for example: 2016, 2018, 2022 etc)
	California Assessment of Student Performance and Progress (CAASPP) Years Requested:
	English Language Proficiency Assessments for California (ELPAC) Years Requested:
	Physical Fitness Test (PFT) School Years Requested:
	California Longitudinal Pupil Achievement Data System (CALPADS) Years Requested:
	Other Data Elements Years Requested:

Please print this survey page for your reference before submitting.

Once you select the Submit button below, your form will be sent to the California Department of Education (CDE) and you will be redirected to the CDE Research Data Request Process web page.