Right To Know Request Form printable pdf download

Right To Know Request Form

RIGHT-TO-KNOW REQUEST FORM

This form is being provided under the provision of Act 3 of 2008 in response to your request. This printable PDF may be A)

completed, scanned and emailed to the address below or B) printed and completed by hand. The form may be submitted by fax,

mail or in person::

In person or by mail: Administrative Office at NativityMiguel School of Scranton

Fax:

570-955-5707

E-mail:

Requestor Information:

Date of Request: ___________________________________________________________________________________________

Name: ___________________________________________________________________________________________________

Address: __________________________________________________________________________________________________

City, State, Zip: _____________________________________________________________________________________________

Telephone Number (s): _______________________________________________________________________________________

Records Requested:

Do you want copies?

Yes

If so, do you want them mailed?

Yes

Do you want to inspect the records?

Yes

School Use Only

Received By

_______________________________________________________________

Date and Time Received: ________________________________________________________

Date Response Due: ____________________________________________________________

(five business days)

1 Knox Road|Scranton, PA 18505|p:570-955-5176|f:570-955-5707

Right To Know Request Form