LOS ANGELES SCHOOL UNIFIED SCHOOL DISTRICT
INVESTING IN LAUSD
Request a Certificate
To request a certificate, please fill out the following form. Items marked with an asterisk (*) are required information.
if you have any questions while completing this form please contact
Veronica Aguilar
TEL: (213) 241-4657
EML: veronica.aguilar@lausd.net
Date of Request*
Name of Person Requesting *
Full name of (Organization/Employee/Staff/Teacher/Student) that is being recognized: *
Description of what individual/organization is being recognized for: *
***Certificate of Retirement Only
Employee Number
Total years of service with LAUSD:
Current Title of Employee
Last Place of Employment:
Programs Participated In:
Special Awards/Recognitions:
Date Certificate Needed By: *
Person Picking Up Certificate :
Name*
Phone*
Email*
Location where certificate will be picked up*
Beaudry LAUSD Headquarters
Additional Comments:
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