Schrank Hall North 153, + 5002
Phone: 330-972-6511
http://www.uakron.edu/testing
Receipt Number
Office use only
Date: ___________________
Survey Services Request Form
Contact Information________________________________________________________________________
Last Name:
First Name:
UAnet ID:
@uakron.edu
Phone:________________________________
Survey Information_________________________________________________________________________
Form Color:
Blue
Green
Number of questions:
Output Options____________________________________________________________________________
Electronic Raw Data File:
Yes
No
Electronic Frequency File:
Yes
No
Office use only_____________________________________________________________________________
Number of Forms Scanned: __________________________
Date Scanned: ______________________________________
File Name:
______________________________________
Jun 2012
Survey Scanning Procedure and Information Sheet
Computer Based Assessment & Evaluation is located in Schrank Hall North 153. We can process the two
standard forms used by The University of Akron (the green standard answer sheet, or the blue standard survey
sheet). There are two output options and you may choose either one or both. The first type of output is a
simple text file containing the raw data lifted from the scan forms, one record per sheet scanned.
The following describes the output format of the two standard sheet types.
Green Standard Answer Sheet:
Position Fields
Output
1-5
Index
0-9
6-14
STUDENT ID
0-9
15-35
LAST-FIRST-MI A-Z
36-45
DEPT-CRS-SEC 0-9
46-47
TEST NUMBER 01, 02, …, 12
48
ALT ANSWER Y or blank
49
TEST FORM
A, B, or C
50-229
RESPONSES
A-E
Blue Standard Survey Sheet:
Position
Fields
1-5
Index
6-9
GROUP ID
10-18
INDIVIDUAL ID
19-39
SECTION A
40
SECTION B1
41-42
SECTION B2
43-102
SECTION D
103-192
SECTION C
Output
0-9
0-9
0-9
A-Z
A or B
0-9
0-9
Y, N, or Z
Note: A ‘?’ in your output indicates a multiple grid response.
The second output option generates a simple frequency listing file and will require extra control sheets. The
control sheets are used to indicate the number of questions in each survey group. Your survey may have more
than one group. For example, you may ask 10 questions of group A and 15 questions of group B. Simply place
a control sheet indicating the number of questions preceding each group and submit them for processing. If you
use the blue form, frequencies are computed only for the data in section D.
A Green Control Sheet uses the nine element STUDENT ID field. Fill the first six elements with 8’s and the
remaining three elements with the number of questions in the survey group.
A Blue Control Sheet uses the four element GROUP ID field. Fill the first two elements with 8’s and the last
two elements with the number of questions in the survey group.
Green Control Sheet
Field
STUDENT ID
Required
Input
888888055
Blue Control Sheet
Field
GROUP ID Required
Input
8855
Surveys must be delivered to and retrieved from SHN Room 153 in person. Each survey submitted for
processing must have a current completed Survey Services Request Form attached. You may refer to our web
site for our hours of operation ( http://www.uakron.edu/testing ). A ticket will be issued to you when you
deliver your survey for processing. Liability issues require that this ticket be presented before we can release
your survey results. Each survey request requires a signature at delivery and another when retrieving survey
results. Liability issues also prevent us from altering scan forms in any way. Thus for best results, please take a
few minutes to ensure that all scan sheets have been properly filled in (#2 pencil only, pen will be rejected) and
are in the correct order before you check them in. Your output files will be sent to your uakron email address.
Jun 2012