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Application

This page provides the application forms required to request Arkansas APCD data. It is important to review the APCD Data Dictionaries, the Arkansas APCD Data Attributes, and the other resources found on Understanding the Data  BEFORE completing the data request. These resources will provide context and information to help the data requester complete the application forms.

After resource review, complete the data request application, data element selection list, and data management plan to request data. Submit these forms through ????? by creating an Application Submission ticket on our Data Request Support Portal

For assistance with this process send an email to: (support email) please create a Data Inquiry ticket on our Data Request Support Portal

Form Name

Document

Notes

Data Request Application

View filename190611 Data Request application FILLABLE Updated.pdf

Please go to the APCD Data Request Support Portal, and select Data Request Application.

When submitting the data request application

:

  • Include a separate document containing the requested Evaluation Criteria when submitting the data request application.

  • Include CVs or resumes of the project participants/researchers.

Data Element Selection List

Kathy, we probably need a space for these

Select

you will need to attach documents for:

  • Key Participants / Investigators CVs or resumes.

  • Other Project Participants: name, role, organization

Data Element Selection List

Data Request Data Element Lists

Review the spreadsheet for each file type you will be requesting and select the fields required for this data request.

Data Management Plan

View file
nameData Management Plan FINAL.pdf

Provide documentation that details the collection, storage, access, sharing, and security of the environment in which the data from the data request will be stored.

The HTI APCD template can be used. If these data management documents already exist, they may be submitted as long as they contain all the information requested in the template.

Data Return / Destruction Plan

Project Completion

Form Name

Document

Notes

Project extension / data destruction form

View file
name210301 Certification of project completion and destruction FILLABLE FINAL.pdf

To be filled in at the end of the project.

Use this form to request an extension of your project end date, or to confirm that your project is complete and you have destroyed the data.

See Completing the Project