WAC 132J-276-900   Appendix "A" -- Request for public record to Community College District No. 10.  

APPENDIX "A"

REQUEST FOR PUBLIC RECORD TO

COMMUNITY COLLEGE DISTRICT NO. 10
(a) . . . . . . . . . . . .

Signature		 . . . . . . . . . . . . . . . . . . . . . . .

Signature (Please Print)
. . . . . . . . . . . .

Name of Organization, if Applicable
. . . . . . . . . . . .

Mailing Address of Applicant		 . . . . . . . . . . . . .

Phone Number
(b) . . . . . . . . . . . .

Date Request Made at Community

College District No. 10		 . . . . . . . . . . . . .

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 No. 10's Current Index . . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
Request: Approved . . . . . By . . . . . . . . . . . .
  Date Public Records Officer
Denied Date . . . . . . . . . . . .
Reasons for Denial . . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
Referred to . . . . . . . . . . . By . . . . . . . . . . . .
  Date Public Records Officer




[Order 73-2, Appendix A (codified as WAC 132J-276-900), filed 5/14/73.]