Application for Statistical Consulting Services
To Obtain Statistical Design Consulting, fill out the attached application form and return it to Teena Seele as indicated below. A consultant will then be assigned to you, and will contact you within 3 working days to arrange an initial meeting. For students using the service, we require the signature of the major professor or research sponsor and his/her attendance at this meeting. Return completed application to: Teena Seele, (Room 244 MATH), seele@stat.purdue.edu
For Office Use Only: Date Received ____________ File Number ____________
Date/Consultant ____________
Date/Consultant ____________
Date/Consultant ____________
Name: (Last/First) ___________________________________________ Date: ______________
Department (full name)____________________________________________________________
Campus Mailing Address (BOTH DEPT/BLDG abbreviation) ____________________________
Phone: (Office)______________________ (Home) _______________________________
Electronic mail address ______________________________________________________
Which is the best way to contact you? E-mail ____ Office Phone____ Home Phone ____
______ Faculty ______ Ph.D. Student _______ Undergrad
______ Staff ______ M.S. Student _______Other: (Specify)____________________
If Student: Major Professor: (Last/First)_____________________________Phone__________
Major Professor campus mailing address (BOTH DEPT/BLDG abb.)_______________
List statistics courses taken and statistical computing experience:
Stage of Research: ___________ Design (no data collected yet)
___________ Presently collecting data
___________ Analysis (all data has been collected)
If design stage is complete, was a statistician consulted for design? _____________________
If so, give name(s)____________________________________________________
Expected completion date of project ______________________________________
Estimated number of consulting hours needed this semester ______________________
The results of this research will probably be published as (check all that apply):
__M.S. Thesis __Ph.D. Dissertation __Tech Report __Journal Article ____Other
Is this research supported by a grant or contract?______________________________
If so, give details:
Signature: Applicant __________________________________
Major Prof./Research Sponsor ______________________________________
(Signature required if you are a student.)
Give a brief description of your research including:
Purpose:
Description of variables to be measured:
Research questions that you want to address using statistical methods:
Statistical Issues:
If there are papers about previous studies of a similar nature which might
aid us in helping you, please attach copies.
