Service Record Request

Request for Service Record

Required

Namerequired
First Name
Maiden (optional)
Last Name
Last Name (Name while Employed with District)required
Email Addressrequired
Employee Number (if known)
Must contain only numbers
Phone Numberrequired
Must contain only numbers
Campus/Departmentrequired
Currently Employed with TMISDrequired
Last 4 of Social Securityrequired
Must contain only numbers
Mail Service Record to:
District Name:required
Attention:required
Address:
City, State, Zip Code
Email Copy of Service Record to Requestor:required
I authorize Tuloso Midway ISD to release my records per the information provided above:required
Date
Must contain a date in M/D/YYYY format
Please allow 30 days from date of submission for receipt of Service Record.