PDFWAC 132K-276-990

Appendix A—Request for public records.

Appendix "A"
Request for public record to
Community College District No. 11
(a)
. . . .
Signature
. . . . . . . . . . . . . . . . . . . .
Signature (Please Print)
 
. . . .
Name of Organization, if Applicable
 
. . . .
Mailing Address of Applicant
. . . . . . . . . . . . .
Phone Number
(b)
. . . .
Date request made at Community
College District No. 11
. . . . . . . . . . . . .
Time of Day
Request Made
(c)
Nature of Request . . . .
 
. . . .
 
. . . .
 
. . . .
(d)
Identification Reference on Current Index . . . .
 
 
Please Describe
 
. . . .
 
. . . .
 
. . . .
(e)
Description of Record, or Matter, Requested if not Identifiable by Reference to the Community College District No. 11's Current Index . . . .
 
. . . .
 
. . . .
 
. . . .
Request: Approved . . . . . . . .
By. . . .
 
Date
Public Records Officer
Denied Date . . . .
 
Reasons for Denial: . . . .
. . . .
. . . .
Referred to . . . .
Date . . . .
 
By . . . .
Public Records Officer
[Order 18, Appendix A (codified as WAC 132K-276-990), filed 5/11/73.]