JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Employee Service Record Request
Please complete the request below and allow 30 business days to process from the date requested. Employees resigning and requesting a current year service record should be advised that the service record will not be available until payroll has completed your final paycheck for the current year.
* If resigning/retiring at the end of the school year, your service record will be available after July 5th.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Previous Name while employed at DISD
Your answer
Last 4 of Social Security
*
Your answer
Position Held
*
Your answer
Last school year employed with DISD
Your answer
How would you like to receive the service records
*
Send copy to my personal email address
Email service record to a District
Mail a hard copy to the address provided below
Email for District to send records (type N/A if requesting records to be mailed out)
*
Your answer
If requesting service record to be mailed, enter mailing address below
Attention/Name (School District, if any), Address, City, State, Zip
Your answer
Phone Number
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Dilley Independent School District.
Report Abuse
Forms
