GFA (LOCAL) change to procedure
EXHIBIT
Weapons-Free Zone (WFZ) Application
Please use additional pages as necessary and attach any supporting materials.
Originator: ________________________________________________________________________________
Name Position
________________________________________________________________________________
Department Phone Email Address
Request to establish a New Permanent WFZ: ______
Request to establish a Temporary WFZ: Date(s) ________________ Time ______________
Request to modify an existing WFZ: _______________ Original Permit Number or Location _______________
Request to eliminate an existing WFZ: ____________ Original Permit Number or Location _______________
Exact relevant area: _________________________________________________________________________
Please provide a recommendation and rationale based on criteria listed in the policy
(See GFA LOCAL at http://www.hccs.edu/district/about-us/policies/hcc-board-policy-manual-section-g/
):
Originator Signature: ___________________________________________________________________
Date: ________________________________________________________________________________
For WFZ Committee Use Only:
Permit Number: (i.e., CC:SC:3:504)
Location:
GFA (LOCAL) change to procedure
EXHIBIT
TO BE COMPLETED BY THE COLLEGE OPERATIONS OFFICER (COO)
Please provide all alternatives/solutions considered and the recommendation.
TO BE COMPLETED BY THE EXECUTIVE REPRESENTATIVE (PRESIDENT/VICE CHANCELLOR)
Please provide your recommendation and any comments.
COMMITTEE RECOMMENDATION
FINAL APPROVAL
Chancellor/Designee Signature: ________________________________________________________________
Date
__________ Recommendation supported __________ Recommendation not supported
__________ Recommendation Resolved
Reason for Approval/Denial: _______________________________________________________________
All alternatives considered: ________________________________________________________________
P/VC Signature: _________________________________________________________________________
__________ Approval __________ Denial
Reason for Approval/Denial: _______________________________________________________________
Signature: ______________________________________________________________________________
__________ Recommendation supported __________ Recommendation not supported
__________Recommendation Resolved
Reason: _______________________________________________________________________________
All alternatives considered: _______________________________________________________________
COO Signature: _________________________________________________________________________