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. 4
(a) | . . . . . . . . . . .. Name (please print) | . . . . . . . . . . .. Signature | ||
. . . . . . . . . . .. Name of Organization, if Applicable | ||||
. . . . . . . . . . .. Mailing Address of Applicant | . . . . . . . . . . .. Phone Number | |||
(b) | . . . . . . . . . . .. Date Request Made | . . . . . . . . . . .. Time of Day Request Made | ||
(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 Community College District No. 4 | |||
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Request: | APPROVED . . . . . . . . . . .. | DENIED . . . . . . . . . . .. | Date . . . . . . . . . . .. | |
By | . . . . . . . . . . .. Name | . . . . . . . . . . .. Title | ||
Reasons for Denial: . . . . . . . . . . .. | ||||
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Referred to . . . . . . . . . . .. | Date . . . . . . . . . . .. | |||
By | . . . . . . . . . . .. Name | . . . . . . . . . . .. Title |
Wash. Admin. Code § 132D-276-140
Statutory Authority: RCW 28B.50.140. 89-11-024 (Order 89-07), § 132D-276-140, filed 5/11/89.