Transcripts / Records Request

POMONA UNIFIED SCHOOL DISTRICT

Transcripts/Records Request Form

Please note: This request is only for those who attended/graduated prior to 2005. All others must request records directly with the school by clicking here (at the top click "select a school.")

If you have any questions, please contact our office:

Pupil Resources Department

851 S. Hamilton Blvd., Pomona CA, 91766

(909)397-4800 x28200

M-F 8:00 AM-4:30 PM

First Name*

During time of enrollment

Answer Required

Last Name*

During time of enrollment

Answer Required

Phone Number*

Answer Required

Date of Birth:*

Answer Required

School last attended:*

Answer Required

Year graduated:*

If you did not graduate, please indicate N/A and move on to the next question.

Answer Required

If you did not graduate, please indicate the year last attended & grade level:

Answer Required

Middle school attended:*

Answer Required

Middle school completed:*

Answer Required

Yes

Elementary school attended:*

Answer Required

Elementary school completed*

Answer Required

Yes

Type of record needed:*

Please note: Prior to 2013, schools were not required to archive immunization records.

Answer Required

High School

Middle School

Elementary School

I.E.P.

Immunization Record

Other:

Quantity needed:*

Answer Required

Please provide details of the delivery method here (fax or address):*

If picking up, please indicate N/A

Answer Required

Please upload a valid I.D.*

Answer Required

Choose a file or drag it here.

Signature*

Signature Required

Please fix the highlighted areas below before submitting.

Transcripts / Records Request

POMONA UNIFIED SCHOOL DISTRICT