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Request for Retiree Certificate Copy

Board District 1 Request for Proclamations & Certificates

Please allow three weeks for delivery. Certificates will be sent via school mail. If you have any questions, please contact Veronica Aguilar at (213) 241-6382 or [email protected]

Retiree Name*

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Position*

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School

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Numbers of years of service

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Titles and Positions*

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Retirement Date/Date on Certificate*

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Due Date*

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Outstanding achievements or recognitions

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Upload additional information

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Choose a file or drag it here.

Requested By*

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Requestor's Email and Phone number *

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Please mail certificate to*

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Confirmation Email

Confirmation Email *

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