REQUEST TO INSPECT AND/OR COPY RECORDS

Date: __________________________

To:	Freedom of Information Officer  
c/o Indian Valley Vocational Center
600 Lions Road
Sandwich, IL  60548
815/786-9873
lrottivvc@yahoo.com

I hereby request to:   	inspect 	copy* the following records:

(Please describe requested records as specifically as possible, attaching additional page if necessary.)
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*There is no copying fee for the first 50 black and white standard-sized copies. The fee for additional
copies is 15¢ per page. Actual cost will be charged for copies of documents not of standard size, and for
the recording medium (e.g,. compact disk, tape, DVD), when applicable.

Is this request for a commercial purpose?   	 	 		Yes		No

Are you requesting a waiver or reduction of copying fees?  		Yes		No

If yes, what is the purpose of this request? _________________________________

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Requester’s (Printed) Name
								
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 DO NOT WRITE IN THIS SPACE

 ___________________________
        DATE RECEIVED BY IVVC

	
Requester’s Signature  
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	Requester’s Address
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	Requester’s Phone Number
									_________________________________	Requester’s E-mail Address