Form for leaders who plan to administer the survey

Thank you for your interest in using Team Member Perceptions of Instructional Change Collaborations (TM-PICC) Survey. Please answer these questions and we will distribute the survey to your team members and send you a report of the results.

Prior to filling out this form, take a moment to download and fill out the Team Members List (Comma Separated Values 45bytes Nov15 24) with the names, emails, and team(s) identifier of those you'd like to share the survey with.

Contact InformationFirst Name:
* required
Last Name:
* required
Title:

If you prefer another title, please share with us:

Email address:
* required

Institution:

Using the SurveyTell us why you are interested in using this survey:

Please describe how you plan to identify the team(s) (ex. team names, numbers, etc.):

Please upload your Team Members List CSV using the formatted file linked at the top of this page for sharing the survey with your team(s):

Upload CSV file

Select the file: Make sure it has an appropriate suffix (e.g. .doc) or specify the type in the Optional Fields below

Show Optional Fields

Title: A descriptive, human readable title.

e.g. 'Student Handout for Sauerkraut Assignment'

Description: A very brief description of the file.

File Type:

The system will attempt to determine the correct file type based on the name of the file you've selected. Choosing the correct file type here will override that.

File Name:

e.g. 'student_handout'
This will be the name of the downloaded file. By default the system will generate this based on the title you specified and the type of file. If you specify a name here it will over-ride the automatically generated name. This is generally only useful when uploading file of a type not recognized by the system (not in the list of file types above). In that situation choose File Type: Unknown Binary and include the appropriate suffix in the file name here. e.g. myfile.m3z Avoid spaces or special characters in the file names.

We typically leave the survey open for 2 weeks and send up to 2 reminders.

We will send you a survey report within 1-3 business days of the survey close date.

Note that the response rate will be much better if you send an email to your team members (link opens in new tab) in advance to let them know about the survey and encourage them to participate.

When would you like us to send out the survey?

When would you like us to close the survey?

Please use this space to let us know anything else that might be useful or to ask questions:

Name Email