request for public record to committee on advanced tuition payment |
(a). . . . |
Name (please print) | Signature |
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Name or Organization, if applicable |
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Mailing Address of Applicant | Phone Number |
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(b). . . . |
Date Request Made | Time of Day Request Made |
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(c) Nature of Request. . . . |
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(d) Identification Reference on Current Index (Please describe) |
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(e) Description of Record, or Matter, Requested if not Identifiable by Reference to the Committee on Advanced Tuition Payment Index |
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Request: approved. . . . | denied. . . . | Date. . . . |
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By. . . . |
Name | Title |
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Reasons for Denial:. . . . |
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. . . . |
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Referred to. . . . | Date. . . . |
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By. . . . |
Name | Title |
[Statutory Authority: RCW
28B.95.030 (9)(e). WSR 98-23-009, § 14-276-140, filed 11/5/98, effective 12/6/98.]