Fillable Camera Appeal Form Submit this completed form to (Inver Hills Community College)

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Camera Appeal Form Submit this completed form to (Inver Hills Community College)

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Camera Appeal Form
Submit this completed form to the Director of Public Safety and Security. The Director of Public
Safety and Security, the Director of Facilities, and the VP of Finance and Operations will review
the appeal and communicate resolution within 30 days of receipt.
Date: ________________________________ Campus: _____________________________
Name: _______________________________
Camera Location (please include specific information such as building, room, hallway, etc.):
______________________________________________________________________________
______________________________________________________________________________
Reason for appeal:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Additional comments:
______________________________________________________________________________
______________________________________________________________________________
--------------------------------------------------------------------------------------------------------------------
Administration only:
Date of review: _____________________________
Name and Title of employee reviewing appeal: _______________________________________
Approved: ____ Yes ____ No
Comments: ____________________________________________________________________
Additional information needed: ____ Yes ____ No
If yes, please explain additional information needed:
______________________________________________________________________________
______________________________________________________________________________
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Camera Appeal Form Submit this completed form to (Inver Hills Community College)

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Completed 4 February 2021

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