Transcripts / Records Request

POMONA UNIFIED SCHOOL DISTRICT - MICRO-FILM DEPARTMENT

851 S. Hamilton Blvd., Pomona, CA 91766 - Ph: (909) 397-4800 x28200 - Fax: (909) 622-3027

Fill out this request form if you were enrolled in PUSD during 2004 or any years prior to 2004

If you attended anytime from 2005 to the current school year, contact the last school attended to request your transcript. For your convenience, GO HERE and click "select a school" at the top.

If you received a GED through PUSD Adult School, contact the registrar at the Adult & Career Ed. office at (909) 469-2333 to request a copy of your transcript or go to https://ace.pusd.org/

First Name*

during time of enrollment

Answer Required

Last Name*

during time of enrollment/maiden name

Answer Required

Phone Number*

Answer Required

Date of Birth:*

Answer Required

Type of record(s) needed:*

Answer Required

High School

Middle School

Elementary School

Immunization Record

ALL

High School name (PUSD):*

Answer Required

Graduated

Answer Required

Yes

Year graduated:*

type N/A if you did not graduate

Answer Required

Non-Grad/Last Year Attended:*

type N/A if this does not apply to you

Answer Required

Middle School name (PUSD)*

Answer Required

Completed*

Answer Required

Yes

n/a

Elementary school name (PUSD)*

Answer Required

Completed*

Answer Required

Yes

n/a

E-mail (if applicable)

Answer Required

Mailing Address (if applicable)

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Upload 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 - MICRO-FILM DEPARTMENT