PUBLIC RECORD(S) REQUEST
(See attached "Public Records Requests Procedure" for additional instructions.)
Parties requesting public records are encouraged to complete the Public Record(s) Request form and submit it,
accompanied by a check made out to "Clatsop Community College" in the amount of $25, to the Vice President,
Finance and Operations. This will allow the College to contact you for clarification of your request and notify you
when the records are available for pickup. Requests will be accepted or denied in accordance with the Public
Records Requests Procedure.
Name of Requesting Party (i.e., business name) Date
MAILING ADDRESS OF REQUESTING PARTY:
Street City
State Zip Telephone
E-Mail Address
Preferred method of obtaining public records
(please make your preference known by initializing
the corresponding line.)
Requesting party will pick up.
College will deliver via U.S. Postal Service.
It is to everyone's advantage if requests are as precise and as narrow as possible. The requester benefits because the
request can be processed more quickly and inexpensively. The college benefits because it can do a better job of
responding to the request. The Oregon Public Records laws work best when both the requester and the college act
cooperatively.
What public record(s) are you requesting and what is the intended purpose of the request? (Please specify.)
(This information is used to determine whether or not the requested public records are exempt from disclosure,
qualify for fee reduction or waiver, or if the documents meet the "public interest test".)
I certify that the statements contained in this form are true and correct to the best of my knowledge and belief, that I
have read and understood the Clatsop Community College Public Records Requests Procedure, and that I have
attached the required $25 deposit with this formal request. (Where fees are waived or request is denied, College will
promptly return deposit payment.)
Name of Individual Requesting Records (please print)
Signature of Individual Submitting Request for Records Date