Outgoing Service Records Request-Non Exempt

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Please use this form if you are: Non-Exempt/ Clerical, Technical, Paraprofessional, Auxiliary
and needing a service record sent to you or your new school district. Once Crosby ISD has forwarded original service records, they must be kept by the former employee for future use. When a request is made ONLY Crosby ISD service record(s) will be sent to the new district.

Personal Email address

Last Name *

First Name *

Other Names

Personal Home Address Street Number *

Personal Home Address Street Name *

Personal Home Address City *

Personal Home Address State *

Personal Home Address Zip Code *

Dates Employed *

Records Needed *

Service Record

Transcripts

Please choose a delivery method for original service record *

Pick up at Human Resources Office

Send to U.S. Postal Address

Email address

Required

Please add the email address you need your service record emailed to.

If delivery method is U.S. Postal Service please add the address below (name of recipient and address)

Please forward service record(s)/transcript(s) to new district (contact name/email address or contact name/USPS address)

Submit

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