FOIA Request

Full Name *

Street Address/Post Office Box *

City *

State *

Zip Code *

Area Code + Telephone Number *

Area Code + Fax Number

E-Mail Address

Description of Records Requested Identify the records as clearly and specifically as possible. Please provide sufficient information which would be helpful in identifying and locating the requested records, such as document title, etc. *

Maximum Search Fee Enter the maximum search fee the person making this request is prepared to pay. If you do not enter an amount Roxana School District will assume you are willing to pay at least $25 for this search. There is no charge for the first 50 pages. Each additional page is 15¢ per page.

Type of Requester * An individual seeking information for personal use and not for commercial use.
Affiliated with an educational or noncommercial scientific institution, and this request is made for scholarly or scientific purpose and not for commercial use.
Affiliated with a private corporation and seeking information for the use in the company's business.
A representative of the news media

If a representative of the news media please provide: Affiliated Group and what is your broadcast medium. Ex: Alton Telegraph, Newspaper

Additional Information and/or Comments

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Roxana Community Unit 1

FOIA Request

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