Livingston ISD

Please Fill Out The Request for Personnel Records Below

Printed Name of Employee

Personal E-Mail Address

Phone Number

Reaquired field: Home Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Date of Request Being Submitted

Social Security Number (000-00-0000)

Reason for request for records?

Reaquired field: Resigning from LISD and need my records mailed to the District address listed on bottom of form

Reaquired field: I have not resigned, but requesting copies of my records listed below

Reaquired field: Need official records sent to the University listed below for my degree program

Reaquired field: Other

Items Requested: Please check all that apply

Reaquired field: Service Record

Reaquired field: Transcripts

Reaquired field: Other

Method of delivery for records

Reaquired field: Mail to the District

Reaquired field: E-Mail to the District

Reaquired field: Pick up at Administration Building

Mailing Address for Records to be Returned Through the Mail

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

E-mail address of receiving District

If Picking up records personally from the Administration office, please list the name of person who will be picking up:

Please initial here:

FOR OFFICE USE ONLY:

DATE REQUEST RECEIVED:

DATE REQUEST MAILED:

Email a copy to

optional

Required Fields

District	Campus	Directory
	CAMPUS