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Service Record Request Form

Required

Clear Creek ISD will prepare one original service record for former employees. If CCISD has provided you an original service record in the past, please contact the school district where you were most recently employed to obtain the original.  Please add a note when requesting service records for an active employee enrolling in a graduate program.

Please allow up to 30 days after your final day of service or date of the request for processing.

Please provide the following information. Your request will be sent via email to the CCISD Certification Specialist. Depending on your preference, your service record will be emailed or mailed to your new District within 30 days of the date of the request. Service records must be transferred directly from district-to-district to be considered official documents.

Employee Information

Full Name (At Time of Employment)required
First Name
Middle (optional)
Last Name
Must contain only numbers

Employment Information

Approximate Dates Worked
Must contain a date in M/D/YYYY format
Must contain a date in M/D/YYYY format
Please share any additional information that could be helpful to locate your records

Service Record Delivery Information

Please tell us where to send the requested service record. Our preference is to send records via email. Please note, the email address provided must be an official district email to be considered an official document. We can also mail printed records.

New District Point of Contactrequired
Name

Processing Time

Please allow up to 30 days from the date of the request or your final working day (whichever came last) for your service record to be processed. You will receive a confirmation email upon completing this form. Please check your spam/junk inbox if you do not receive the email confirmation.

Thank you!