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Form for requesting the opening of a survey

Who can create a questionnaire?

All University staff (civil servants, contract staff, doctoral students and emeriti). Accounts in the Lime Survey tool are managed manually by the DGDNum. The only requirement is that you have a University of Lille email address.

This service provided by the Digital Department enables users to easily create online questionnaires and use the results, either directly in a report provided by the tool, or by exporting them to a file (Excel or other) for specific processing.

Your Profile
(This question is mandatory)
Name:
(This question is mandatory)
First name:
(This question is mandatory)
Email (university email only "@univ-lille.fr"):
(This question is mandatory)
Department, Component, Laboratory:
(This question is mandatory)
Your profile:
"You have requested the opening of a personal data processing referencing form (RGPD). The Limesurvey team will inform you by email when it goes online."
Information about the Survey
(This question is mandatory)
Name of survey:
(This question is mandatory)
Purpose of the survey:

Structure template (in LSS format) (OPTIONAL):  :

Please note: no accents, special characters or spaces in the name (example: my_file.lss)
  Title Comment File name
Copy of an existing questionnaire (question ID number) (OPTIONAL) :
(This question is mandatory)
Population covered by the survey?

Compulsory examination of the application by the ODIF

+ more information: https://odif.univ-lille.fr/

(This question is mandatory)
Any other audience?
(This question is mandatory)
Provisional timetable
(This question is mandatory)

Has the survey request been submitted to the DPO for RGPD compliance approval?

* RGPD / More information about RGPD

(This question is mandatory)

IF YES, folder number :

please contact the Data Protection Officer (DPO)

dpo@univ-lille.fr

(This question is mandatory)
Survey format:
Population concerned by the survey (this form only concerns staff surveys):
(This question is mandatory)
Your need for support:

Do you need co-admins or collaborators to complete this questionnaire  (please note that only university email "@univ-lille.fr" *) :

* if that's not possible, we'll use sponsorship as a second step.

Other comments:

Duration of retention of user data

Data relating to the creation of user accounts as well as data collected by survey forms will be kept for a period of six months from the closure of the surveys concerned. Beyond that, this data may be archived on a separate medium with limited access, in accordance with the rules applicable to public and private archives.