WAC 148-276-140   Adoption of form.  The school 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

WASHINGTON STATE SCHOOL FOR THE DEAF

(a) . . . . . . . . . . . .
Name (please print) Signature
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Name of Organization, if applicable
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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 Washington State School for the Deaf
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Request: APPROVED . . . . . . DENIED . . . . . . Date . . . . . . . . . . . .
By . . . . . . . . . . . .
Name Title
Reasons for Denial: . . . . . . . . . . . .
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Referred to . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . .
By . . . . . . . . . . . .
Name Title




[Statutory Authority: RCW 72.40.022 and 42.17.250. 90-16-017, § 148-276-140, filed 7/19/90, effective 8/19/90.]