WAC 132G-276-900. Appendix A—Form—Request for public record to the Shoreline Community College

APPENDIX "A" REQUEST FOR PUBLIC RECORD TO SHORELINE COMMUNITY COLLEGE (a) . . . . Name (Please Print) . . . . . . . . . . . . . Signature . . . . Name of Organization, if Applicable . . . . Mailing Address of Applicant . . . . . . . . . . . . . Phone Number (b) . . . . Date Request Made at the Shoreline Community College . . . . . . . . . . . . . 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 Shoreline Community College's Current Index . . . . . . . . . . . . . . . . (f) Purpose of Request if the Request is for a List of Individuals . . . . . . . . . . . . . . . . Request: Approved . . . . By . . . . Date Public Records Officer or his or her designee Denied Date . . . . Reasons for Denial: . . . . . . . . Referred to . . . . Date . . . . By . . . . Public Records Officer or his or her designee (a) . . . . Name (Please Print) . . . . . . . . . . . . . Signature . . . . Name of Organization, if Applicable . . . . Mailing Address of Applicant . . . . . . . . . . . . . Phone Number (b) . . . . Date Request Made at the Shoreline Community College . . . . . . . . . . . . . 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 Shoreline Community College's Current Index . . . . . . . . . . . . . . . . (f) Purpose of Request if the Request is for a List of Individuals . . . . . . . . . . . . . . . . Request: Approved . . . . By . . . . Date Public Records Officer or his or her designee Denied Date . . . . Reasons for Denial: . . . . . . . . Referred to . . . . Date . . . . By . . . . Public Records Officer or his or her designee