Employee Records Request
Page 1 of 1
1.
First Name
*
2.
Last Name
*
3.
Prior First Name
*
4.
Prior Last Name
*
5.
Last Four of Social
*
6.
Phone
*
7.
Email Address
*
8.
Delivery Method
*
--Please Select--
Mail to Address
Pick Up
9.
Delivery Method If you choose to pick up your records we will notify you by phone when they are available. Please fill out the address form if you choose to receive mail to address.
*
Street Address
Address Line 2
City
State
Zip Code
Address Information
10.
Type of Employee
*
Current Employee
Substitute
Former Employee
11.
Documents Requested
*
Service Records
Transcripts
Substitute Service Records
Other Documents
12.
If 'Other Documents' please explain: