Public Records Request
Please note that this request form is not for student records or transcripts. Use this link to find out how to request student records: http://www.4j.lane.edu/communications/studentrecordrequests/
Sign in to Google to save your progress. Learn more
Date of Request *
MM
/
DD
/
YYYY
First Name *
Last Name *
Organization (If Any)
Email Address *
Phone Number *
Requested Format *
Indicate the preferred format for receiving non-exempt public records.
Request Details *
Provide a detailed description of the requested records with enough information to assist staff in locating the record(s).
Date Range *
Narrowing the scope of a request often results in the ability to locate and produce non-exempt records more efficiently. Please enter the date or date range that pertains to your requested records.
Acknowledgment *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of 4j.lane.edu. Report Abuse