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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 mailto:adrs@achiapcd.atlassian.net. by creating an Application Submission ticket on our Data Request Support Portal

For assistance with this process send an email to: mailto:adrs@achiapcd.atlassian.net please create a Data Inquiry ticket on our Data Request Support Portal

190611 Data Request application FILLABLE Updated.pdf

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

Data Return / Destruction Plan

Form Name

Document

Notes

Data Request Application

View file
name

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.

    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.

    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