Washington Administrative Code
Title 132J - Green River College
Chapter 132J-276 - Public records
Section 132J-276-900 - 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 Time of Day Request Made

College District No. 10

(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 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