OPEN PUBLIC RECORDS ACT REQUEST FORM
CAMDEN CITY SCHOOL DISTRICT
1033 Cambridge Street, Camden, New Jersey 08105
Anisah Coppin, Custodian
856.966.2000
OPRAcustodian@camden.k12.nj.us
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IMPORTANT NOTICE:
THE LAST PAGE OF THIS FORM CONTAINS IMPORTANT INFORMATION RELATED TO YOUR RIGHTS CONCERNING GOVERNMENT RECORDS. PLEASE READ IT CAREFULLY.
Requestor Information
First Name *
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Last Name *
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Company
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Mailing Address *
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City *
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State *
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Zip Code *
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Telephone Number *
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Fax Number
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Preferred Delivery *
If you are requesting records containing personal information, please select one: Under penalty of N.J.S.A.2C:28-3, I certify that I HAVE or HAVE NOT been convicted of any indictable offense under the laws of New Jersey, any other state, or the United States.
Record Request Information *
Describe in full detail the records being requested. Note that your preferred method of delivery will only be accommodated if the custodian has the technological means and the integrity of the records will not be jeopardized by such method of delivery.
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Payment Method
Fees:
Letter size pages - $0.05 per page
Legal size pages - $0.07 per page
Other materials (CD, DVD, etc) - Actual cost of materials

Delivery: Delivery / postage fee additional depending upon delivery type.

Extras: Special service charge dependent upon request.
Maximum Authorization Cost ($)
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