BUREAU HENRY STARK REGIONAL OFFICE OF EDUCATION
107 SOUTH STATE STREET
ATKINSON, IL 61235
Phone 309-936-7890

FREEDOM OF INFORMATION ACT

Approval of Request for Public Records

FROM:                                     ____________________________________________________________________

                                    NAME  (Print)

                                    ____________________________________________________________________

ADDRESS (Print)

                                    ____________________________________________________________________

                                    CITY, STATE, ZIP (Print)

 ____________________________________________________________________

 PHONE NUMBER

DESCRIPTION OF REQUESTED RECORD(S):

Your request dated __________________________ for the above captioned records has been approved.

 ____ The documents you requested are enclosed.

 ____ The documents will be made available upon payment of copying costs in the amount of $_________.

 ____ You may inspect the records at __________________________________________________

__________________________________ on ______________________

                                                                        Date

_____________________________ _________________________ ________________________ 

Signature                                               Title                                         Date

Appendix B may be downloaded as a PDF file from THIS LINK.