Records & Information Management
Red Deer College
100 College Blvd
Box 5005
FORM REQUEST
Red Deer, Alberta
CANADA T4N 5H5
Telephone: 403.342.3588
Fax: 403.340.8940
Web-site: www.rdc.ab.ca/rim
The information on this form will be used by Records and Information Management in order to process your RIM USE ONLY
Form Request. The information will be protected in compliance with the provisions of the Freedom of
Information and Protection of Privacy Act of Alberta. TRACKING #
ORIGINATOR INFORMATION
NAME PHONE NUMBER
DEPARTMENT / PROGRAM AREA EMAIL ADDRESS
FORM DETAILS
Does the form currently exist on the RDC Info Index and/or the RIM website? NO YES
NEW FORM FORM REVISION
OWNER OF FORM (Department / Program Area) CONTACT PERSON
DEPARTMENT/PROGRAM AREA PHONE NUMBER DEPT/PROGRAM AREA WEBSITE ADDRESS
SUGGESTED TITLE OF FORM (Subject to Change) SUGGESTED SUBTITLE (If Applicable)
FOIPP STATEMENT
PURPOSE(S) FOR COLLECTION (Include all purposes for collection and uses of information.)
GOVERNING BODIES OR STATUTES RELATING TO INFORMATION COLLECTION
WILL THE INFORMATION BE SHARED WITH ANYONE? RETENTION PERIOD (Minimum One Year)
NO YES WHO?
DEPARTMENT/PROGRAM LEADERSHIP REPRESENTATIVE TITLE PHONE NUMBER
STEPS IN THE FORM PROCESS: EXPECTED TIMELINE:
1. Form Request Submission
2. Form Analysis & Design
3. Form Originator Review
4. From Review/Revision Minimum 6 Weeks
5. Form Originator Approval
6. FOIPP Approval
7. Form Completion
TIMELINES MAY INCREASE FOR EACH FORM ALREADY IN THE QUEUE
FORMS WILL BE PLACED IN THE QUEUE IN THE ORDER THEY ARE SUBMITTED
TIMELINES MAY BE ADJUSTED BASED ON PRIORITY AND/OR THE FOLLOWING CRITERIA:
Is the Form collecting Personal and/or Health Information?
Is the Form to be completed by or directed to an external source? (Student, Community Member, etc.)
Is the Form to be completed by or directed to an employee of the College?
Is the Form conducting a Survey or Questionnaire? (Research Ethics Committee Involvement)
Is the Form required for a Certain Event? Date of Event?
Is this a revision of an existing form? (The form is currently on the RDC Info Index / RIM Website)
Is this a new form? (The form is not currently on the RDC Info Index / RIM Website)
Have you created the form using the Form Design Template provided?
Have you included a completed FOIPP Statement using the sample statements provided?
02/09