College of Education & Human Development

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Partnership Request

For questions regarding requests, please contact Tina Tipton, Starr Lewis, or Brittany Carpenter.

Request Type (Required)

First Name (Required)

Last Name (Required)

Email (Required)

Phone (Required)

with area code ###-###-####

District(s)

School(s)

CEHD Department (Required)

Date Needed (Required)

Are you requesting Professional Development? (Required)

Yes
No

Please describe the area for professional development request

If a specific presenter is desired, please specify (Name, Affiliation)

Anticipated dates for Professional Development

Estimated Funding

If making a request for research, what is the research question?

Please describe the benefits of this research to the district, school, and UofL.

If making a request for data, please specify the data requested/needed.

Source of Data Collection

Survey

Interviews

Observations

Attendance Data

Behavior Data

Academic Data

Other

Specify if "Other"

from the above field

Funding (Required)

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