Freedom of Information Act (FOIA) Request Form

To (FOIA Officer Name):
Please select an option Employee and Personnel Info - Dustha Wahls Fiscal, Budget or Financial Info - Madge Shoot Student and Student Policy Info - Jon Van Dyke Media and College Communications - Kelly Allee

I hereby request to
Inspect Information Receive Information

Documents to inspect or receive

* There is no copying fee for the first 50 black and white standard-sized copies. The fee for additional copies is 15¢ per page. Actual cost will be charged for copies of documents not of standard size, and for the recording medium (e.g,. compact disk, tape, DVD), when applicable.

Is this for a commercial purpose?
Yes No

Are you requesting a waiver or reduction of copying fees?
Yes No

If yes, what is the purpose of this request?


Requestor's Full Name


Requestor's Address


Requestor's Phone Number


Requestor's Email Address


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