Indiana Access to Public Records Request Form
This form is used to submit requests for public records to Delaware Community School Corporation (DCSC) under Indiana’s Access to Public Records Act, Indiana Code § 5-14-3. In accordance with Indiana law, including recent legislative allowances for electronic public records request portals, this form is used to receive, verify, track, and process APRA requests. Requests should identify the records sought with reasonable particularity.

Records or portions of records may be withheld or redacted when required or permitted by law, including student education records protected by FERPA, confidential personnel information, attorney-client privileged communications, and other information exempt from disclosure.

Submission of this form does not guarantee that all requested records are disclosable. DCSC will review and respond to requests in accordance with Indiana law.
Email *
Full Name of person making the request *
Name of Business/Entity the Requester Represents *
Email Address *
Physical Mailing Address *
Responses must include: Street address, city, state, ZIP code  
Are you an Indiana Resident *
I am making this request on behalf of (select one of the following): *
Please describe the public records you are requesting. *
Please identify the records sought with reasonable particularity. Include relevant dates, schools, departments, programs, names, topics, document types, or other details that may help the DCSC locate responsive records.
Beginning Date range for the requested records. *
MM
/
DD
/
YYYY
Ending Date range for the requested records. *
MM
/
DD
/
YYYY
Preferred method of access   *
Purpose of Request *
This information will help DCSC process and prioritize requests consistent with Indiana law. A request will not be denied solely because this field is left unspecified.
Required

I certify that I am not requesting lists of names, addresses, email addresses, or other directory-style information from the School District for a commercial purpose, including selling, advertising, soliciting the purchase of goods or services, or otherwise using the information for commercial solicitation. I understand that, pursuant to Indiana Code § 5-14-3-3, certain lists may not be disclosed to commercial entities for commercial purposes and may not be used by commercial entities for commercial purposes.

 *
Required
I understand that student education records and personally identifiable student information may be protected from disclosure under the Family Educational Rights and Privacy Act, FERPA, and applicable state and federal law. Such records or information may be withheld or redacted before any records are released. *
Required
I understand that records or portions of records may be withheld or redacted as required or permitted by law, including but not limited to attorney-client privileged communications, FERPA-protected student information, confidential personnel information, Social Security numbers, medical information, security-related information, and other records exempt from disclosure under Indiana Code § 5-14-3-4 or other applicable law. *
Required
I understand that fees may apply for copies of public records as permitted by Indiana Code § 5-14-3-8, including applicable copying, media, mailing, or other fees authorized by law. If fees apply, DCSC may provide an estimate and may require payment before copies are produced or released. *
Required
I understand that, pursuant to Indiana Code § 5-14-3-8, fees may apply for copies of public records and, for school corporations or charter schools, a search fee may be charged for time actually spent searching for records in an electronic format that exceeds five hours. Any such search fee may not exceed the lesser of the hourly rate of the person conducting the search or $25 per hour, and may be prorated as permitted by law.
If the requestor is a non-Indiana resident or out-of-state entity, a supplement fee for processing public records will be twenty-five dollars ($25.00) per hour of staff time spent processing the request with a twenty-five dollar ($25.00) minimum.  
 *
Required
To help verify that this request is being submitted by a person, please type the words "DelCom RECORDS" below, including capitalization. *
I certify that this request is being submitted by a person and is not being submitted through automated data scraping, phishing, or other automated bulk-request activity. *
Required
I have read the DCSC policy of Requests for Records and understand the fees which may be charged. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Delaware Community Schools.

Does this form look suspicious? Report

Google Forms