| . . . . . . . . , the undersigned, hereby requests that he be
permitted to inspect and/or copy the public record of
Community College District No. 20 (Walla Walla Community
College) pertaining to |
| Subject: . . . . . . . . . . . . |
| . . . . . . . . . . . . |
| Dated on or about . . . . . . . . . . . . |
| Dated this . . . . . day . . . . . . . . 19. . . . |
| |
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(Signed) |
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Address: . . . . . . . . . . . . |
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Request received . . . . . . . . . . . .
Public Records Officer |
| Request granted . . . . . . . . . . |
Date . . . . . . . . . . . . |
| Index No. and Title . . . . . . . . . . . . |
| Inspection . . . . . . . . . . . . . . |
Date . . . . . . . . . . . . |
| Copy provided . . . . . . . . . . . |
Date . . . . . . . . . . . . |
| Request not granted . . . . . . . |
Date . . . . . . . . . . . . |
| Reason not granted and disposition of matter . . . . . . . . . . . . |
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(Signed) . . . . . . . . . . . .
Public Records Officer |