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Name of School District:______________________________________________

Contact Person/Title:_________________________________________________

Mailing Address:____________________________________________________

Telephone Number:__________________________________________________

E-Mail:____________________________________________________________

Exceptions:________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

(List and provide basis and description of any local exceptions for records retention periods that are specified by board resolution or formal direction of the school board, etc. that differ from those set out in the Colorado School District Records Management Manual. Use additional pages if needed.) 

The above school district hereby requests approval from the Colorado State Archives to follow the colorado school district records management manual, with the  exceptions indicated.

                       

_______________________________________	__________________________
Signature of School District Superintendent or Administrator	Date of Submittal of Request    for Approval

 

Mail Approval Request Form to:  Mr. George Orlowski, Colorado State Archivist, 1313 Sherman Street, Room 1B-20, Denver, CO For further information, contact the Colorado State Archives at (303) 866-2550.

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COLORADO STATE ARCHIVES APPROVAL

Approved By: ___________________________________________

 Date of Approval:  _____________________________________