495B-276-130  <<  495B-276-140 >>   End of Chapter

WAC 495B-276-140

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
bellingham technical college
(a)
. . . .
Name (please print)
. . . .
Signature
 
. . . .
Name or Organization, if applicable
 
. . . .
Mailing Address of Applicant
. . . .
Phone Number
(b)
. . . .
Date Request Made
. . . .
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 Bellingham Technical College Index
 
. . . .
 
. . . .
 
. . . .
(f)
I hereby certify under penalty of perjury under the laws of the state of Washington that these requested records shall not be used to compile a commercial sales list.
dated this . . . . day of . . . . . , 1992 at . . . . , Washington.
Request: approved . . . .
denied . . . .
Date . . . .
By
. . . .
Name
. . . .
Title
Reasons for Denial: . . . .
. . . .
. . . .
Referred to . . . .
Date . . . .
By
. . . .
Name
. . . .
Title
[Statutory Authority: RCW 28B.10.140, 42.30.075 and chapter 34.05 RCW. WSR 93-05-018, § 495B-276-140, filed 2/10/93, effective 3/13/93.]
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