APPENDIX "A"
REQUEST FOR PUBLIC RECORD TO
COLLEGE DISTRICT NO. 10
Signature Signature (Please Print)
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Name of Organization, if Applicable
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Mailing Address of Applicant Phone Number
Date Request Made at Time of Day Request Made
College District No. 10
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Please Describe
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Request: Approved .......... By ...................
Date Public Records Officer
Denied Date .......................
Reasons for Denial
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Referred to ................. By ...................
Date Public Records Officer
Wash. Admin. Code § 132J-276-900
Order 73-2, Appendix A (codified as WAC 132J-276-900), filed 5/14/73.