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Right-to-Know Request Form
 
Date Requested
 
Name of Requestor (Optional)
First Name Last Name
 
Street Address  
City*/State*/Zip    
 
County*  
Telephone  
Email Address  
 
Records Requested*
How would you like to receive the information you requested?*  
 
Provide as much specific detail as possible so the agency can identify the information.*  
 
Do you want copies?
Do you want to inspect the records?
Do you want certified copies of records?
 
  

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111111110011100111001111110001111111001011110011111001111111
111111111001100111000000111000000111000000110011111000111111
111111111001000111000000111110000011001100110011111000111111
111111111001001111001111111111110011111100110011111001111111
111111111100001111001111110011110011001100110011001001111111
111111111100011111001111110000000011001100111000000001111111
111111111100011111001111111000000111100001111100000000111111
111111111111111111111111111111111111111111111111111100111111
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Type These Characters to Process:
 
 
* Note: A single asterisk(*) designates a required field.
 
 
Right-to-Know Officer:  Brian D. Barnhart, Ed.D

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