Data Request Form

DATA REQUEST FORM
Human Resources, HR Service Center
Skytop Office Bldg, 443-4042

This form may be used to request mailing lists in Excel format, employee data reports, and employee population counts. The requester must abide by the Access to HR Data policy in the University Policies web site.

For mailings that include the Chancellor, Provost, SVP's/VP's, and/or deans/associate deans, a sample of the mailing must be provided to the Office of Human Resources and be approved by the associate vice president - chief human resources officer.

Each request for data must be submitted separately and is provided for one-time use for the purpose stated on the form. It is the responsibility of the requestor and the requesting department to obtain a new list from HR for each subsequent use.

The fee is $26 per file. HR must receive an ID before a request can be processed.

Complete the information below and press the "submit" button. You will be contacted by an HR Service Center representative when your request is received.**

**Allow 2-3 days for processing once request and ID are received.

Name:		Date:
Department:		Phone:
Campus Address:		Fax:
E-mail Address:
Billing ID: The Office of Human Resources must receive the hard copy of this ID before a request can be processed. Initials: I have read and agree to the Security Policy


Intended use:	Purpose/topic:
Department Mailing
Other

Data Needed:
Chancellor, Provost, SVP/VP, Deans/Associate Deans
Academic Deans, Directors and Dept Heads
Deans and Directors
Deans, Directors and Dept Heads (includes above three lists) NOTE: data lists are provided for one-time use only.
Deans, Directors and Dept Heads, all Faculty and Exempt Staff
Academic Department Heads and all Faculty
Adjunct Faculty
All Faculty including Adjuncts
All New Hire Faculty including Adjuncts (please include date range in the "other" section, below)
All Faculty (including Adjuncts) and Teaching Assistants
All Faculty (including Adjuncts) and Deans, Directors and Dept Heads
Regular Faculty (Full and Part Time)
Regular Faculty (Full and Part Time) and Deans, Directors and Dept Heads
Regular Full Time Faculty
Regular, Full and Part Time Faculty and Staff, (no student** or temp employees)
Regular, Full and Part Time Faculty and Staff A&S and Maxwell only, (no student or temp employees)
Regular, Full Time Faculty and Staff (no student or temp employees)
Regular, Full Time Faculty and Regular non Bargaining Unit Staff (no student or temp employees)
Regular, Full and Part Time Staff (no student or temp employees)
Regular, Full and Part Time Staff, Auxiliary Svces only, (no student or temp employees)
Regular, Full and Part Time, non Bargaining Unit Staff (no student or temp employees)
All Non-Student Staff (includes temps)
All Non-Student Faculty and Staff (includes temps)
All SU Employees including student and temp employees
All Graduate Assistants (includes RAs, TAs and GAs)
All Bargaining Unit Employees
Minority Faculty and Regular Staff (no students, no temps)
Salaried African American and Hispanic Faculty and Staff (no students, no temps)
Non-Student Part Time and Temp Employees
Part Time, Temporary Faculty
Retirees, home address
Local Retirees, home address (zipcode begins with '13')
Emeritus, home address
Local Emeritus, home address (zipcode begins with '13')
SU Magazine List (Regular Staff and Faculty, excluding SU alumni)
Other, please specify:
Counts based on academic year averages, where employee status is 'active'. *The 'student' classification includes undergraduate and graduate student employees.

Additional Information - check all that apply
Employee Status:	Address Information:
Active	Campus Address
Unpaid Leave of Absence	E-mail Address
Paid Leave of Absence
Special Instructions/Sort by: (Examples: sort by last name, sort by department, list additional fields needed.)
Send Options:
E-mail Excel file *E-mail address where file should be sent:*

Revised - 08/06