Please be advised that all requests received during summer will not be available until August.
Required fields *
First Name  Middle Initial  Last Name 
Prior First Name Prior Last Name
SSN (no dashes)*

Re-enter SSN *
Employee ID if available
Phone *   (xxx-xxx-xxxx)
Email Address*   Confirm  Email Address*  
Employee Type*
Service Records Request Type*
Please explain briefly why you are requesting your service record:*
Method of Delivery*
Street Address 
City  * State  Zip