WAC 132U-276-240   Adoption of form.  The district 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 COMMUNITY COLLEGE DISTRICT NO. 21
(a)	. . . . . . . . . . . . Name (please print)		. . . . . . . . . . . . . . . . . . . . Signature
	. . . . . . . . . . . . Name of Organization, if applicable
	. . . . . . . . . . . . Mailing Address of applicant			. . . . . . . . . . . Phone
(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 Community College District 21
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Request: Approved. . . . .		Denied. . . . .		Date . . . . . . . . . . . .
By	. . . . . . . . . . . . . . . . . Name		. . . . . . . . . . . . . . . . . . . . Title
Reasons for Denial: . . . . . . . . . . . .
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Referred to . . . . . . . . . . . .				Date . . . . . . . . . . . .

[Statutory Authority: RCW 28B.50.130 and 28B.50.140. 88-15-005 (Order 88-03), § 132U-276-240, filed 7/8/88.]