WAC 132K-276-990 Appendix A -- Request for public records.

Appendix "A"

Request for public record to

Community College District No. 11

(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. 11				. . . . . . . . . . . . . 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. 11's Current Index . . . . . . . . . . . .
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	. . . . . . . . . . . .
Request: Approved . . . . . . . .				By . . . . . . . . . . . .
		Date		Public Records Officer
Denied Date . . . . . . . . . . . .
Reasons for Denial: . . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
Referred to . . . . . . . . . . . .				Date . . . . . . . . . . . .
				By . . . . . . . . . . . . Public Records Officer

[Order 18, Appendix A (codified as WAC 132K-276-990), filed 5/11/73.]