Editing previous response:

Please fix the highlighted areas below before submitting.

Employee Service Record Request

Please complete the following form. Once submitted, please allow for a 3-5 day processing period.

First Name*

Answer required for "First Name"

Last Name*

Answer required for "Last Name"

Other Name(s) Records May Be Under:

Answer required for "Other Name(s) Records May Be Under:"

ZCISD Employee ID#*

Answer required for "ZCISD Employee ID#"

Employee Social Security #*

Answer required for "Employee Social Security #"

Birth Date*

Answer required for "Birth Date"

Phone Number*

Answer required for "Phone Number"

Provide Service Record via*

Answer required for "Provide Service Record via"

Mail

Email Address*

Answer required for "Email Address"

Mailing Address*

Answer required for "Mailing Address"

City

Answer required for "City"

Zip/Postal

Answer required for "Zip/Postal"

Employee Status*

Answer required for "Employee Status"

Current Employee

Former Employee

Original Hire Date*

Answer required for "Original Hire Date"

End of Service Date

Answer required for "End of Service Date"

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"