Request for Public Record
Note: It is not required by law that this form be filled out by a person requesting public records. The district may request the document to be filled out or the District may use the document internally as documentation of public records requests.

Notice: A fee will be charged for copying based upon actual cost for providing the information.
Date *
MM
/
DD
/
YYYY
Name *
Address *
Telephone Number *
Email Address *
Nature of Request *
Please read and sign the following statement: *
Records requested (please be as explicit as possible as to the records you desire): *
Signature (Please Print your Name as Your Signature): *
Liberty Elementary School District No. 25
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