PDFWAC 132U-276-240

Adoption of form.

The district hereby adopts for use by all persons requesting inspection and/or copying or copies of its records the following form:
request for public record to
community college district no. 21
(a)
. . . .
Name (please print)
. . . . . . . . . . . . . . . . . . . .
Signature
 
. . . .
Name of Organization, if applicable
 
. . . .
Mailing Address of applicant
. . . . . . . . . . .
Phone
(b)
. . . .
Date Request made
. . . . . . . . . . .
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 21
. . . .
. . . .
Request: Approved . . . . .
Denied . . . . .
Date. . . .
By
. . . . . . . . . . . . . . . . .
Name
. . . . . . . . . . . . . . . . . . . .
Title
Reasons for Denial:. . . .
. . . .
. . . .
Referred to. . . .
Date. . . .
[Statutory Authority: RCW 28B.50.130 and 28B.50.140. WSR 88-15-005 (Order 88-03), § 132U-276-240, filed 7/8/88.]