Lyford High School

Lyford High School

P.O. Box 220 Lyford TX 78569 Ÿ Phone (956) 347-3909 Ÿ Fax (956) 347-5034

REQUEST FOR SCHOOL RECORD

For students who graduated within one year from the current school year.

All other records can be found at the HR office.

Date of Request: ____________________________________ 20 _______________

Name of Requestor: ___________________________________________________

Relationship to Former Student: ¨ Self ¨ Parent ¨ Sibling

Proof of Identity: Drivers License Number: _________________ (copy needed)

If you are requesting a record for someone else, you must also provide a copy of their identification, as well as your own. Record searches may be requested and released for immediate family members only (i.e. father, mother, brother or sister.)

Name on Record: _________________________ Date of Birth: ______________

Requesting the following: (Check all that apply): ¨ Elementary / Jr. High only

¨ High School only ¨ All grades ¨ Dropout ¨ Graduate

Last Grade Attended: _________________ Last Year Attended: _______________

Signature of Requestor: ______________________________________________

Home Number: ________________________Cell Number: _________________

Mailing Address: ___________________________________________________

¨ Will Pick Up ¨ Please Mail Records

**All requests will be completed within 3-5 days or earlier and you will be contacted by phone when request is complete. Request form must be filed in requestor’s cumulative folder upon completion of request.

Thank you!

OFFICE USE ONLY

Request completed by: _______________________ Date: ___________

¨ Record found ¨ Record Not Found ¨ Mailed to address above

¨ Picked up by: _______________ Relation to former student: ______________