Fill - Free fillable Form II.F.1: Request for Designation of Exclusion Zone: (Lone Star College System) PDF form

Form II.F.1: Request for Designation of Exclusion Zone

Any individual may use this form to request that space within the College be

officially designated as an exclusion zone. This form should be submitted to

the Campus Carry Safety Advisory Committee at CampusCarry@LoneStar.edu

at least 30 business days before the designation is necessary.

____________________________________________ ________________________________

Name of Requester Date

Type of designation requested:  Permanent

 Temporary

Detailed description of space requested to be designated as an exclusion zone (attach additional

sheets as necessary): _____________________________________________________________

______________________________________________________________________________

Reason(s) why space should be designated as an exclusion zone (attach additional sheets as

necessary): ____________________________________________________________________

______________________________________________________________________________

I understand that any statement I make on this Form II.F.1 which is false, misleading, or not

made in good faith may be grounds for discipline.

____________________________________ ______________________________________ __________________

Printed Name Signature Date

For Office Use Only Date Received: ___________________________________________

Receiving Employee: _____________________________________ ____________________________________

Printed Name Signature

Fill Online, Printable, Fillable, Blank Form II.F.1: Request for Designation of Exclusion Zone: (Lone Star College System) Form