Mississippi Public Universities
Request for Public Records
 
Date of Request: 9/2/2014
   
Person Requesting:
   
Representing:
   
Mailing Address:
   
City:
   
State:
   
ZIP:
   
Primary Telephone:
   
Secondary Telephone:
   
Primary Email:
   
Secondary Email:
   
Material Requested (Please be as clear and concise as possible.):
   
Review Requested:  Personally Inspect
   Copy of Material
   
Material Provided Via:  Electronic Mail
   Postal Service Mail
   
Additional Instructions:
   
Enter the code below before submitting your form.
   
Please review the form carefully before submitting.
Be sure to enable cookies in your browser before submitting this form. This will allow your information to be inserted into the printable version for your records.
   
 
Note: Actual costs of gathering and reproducing requested materials will be the responsibility of the requesting agent.