GSC Open Records Request Form

Time remaining in this session. When it reaches 0, unsaved work will be lost.

--:--

* = required field

Some content may be updated based on selection

GSC Open Records Request Form

Date:

Requestor's Name:

Phone #:

E-mail Address:

Fax #:

Mailing Address:

City:

State:

Zip:

Under the provisions of the Georgia Open Records Act, the undersigned hereby respectfully requests permission to inspect and/or obtain photocopies of the following records in the possession of the following Department of Gordon State College:

(Department)

If applicable, the undersigned person requesting such records agrees to pay the institution a fee of ten (.10) cents per page for photocopy service, and any additional fees required for certification of documents, or for personnel costs associated with the search for and retrieval of such records.

(Signature of person requesting records)

Requested Records:

How do you wish to receive the requested information?

Mail

Fax

E-mail

Visit

*Requests for student records are governed by the Family Educational Rights and Privacy Act (FERPA). *

FERPA Code - If Applicable)

Please wait for files to finish uploading

Recaptcha response