Lodi High School Alumni Verification of Graduation for Employment Request Form
This electronic form serves to provide Lodi High School Alumni with the opportunity to submit a request for Verification of Graduation for Employment. This request must be submitted by the individual indicated below. No other persons shall be permitted to submit this form on the behalf of another without written consent from the Principal of Lodi High School. Any attempt by any other persons shall be considered fraud and may lead to criminal charges.
Last Name *
First Name *
Maiden Name (if applicable)
Year of Graduation *
Date of Birth *
Current Telephone Number *
Email
Current Mailing Address *
EMPLOYER/AGENCY NAME *
EMPLOYER/AGENCY MAILING ADDRESS
EMPLOYER/AGENCY PHONE # *
EMPLOYER/AGENCY FAX # *
EMPLOYER/AGENCY CONTACT NAME *
EMPLOYER/AGENCY EMAIL
ELECTRONIC SIGNATURE of LODI HIGH SCHOOL ALUMNI
By entering your Electronic Signature, you are agreeing to the terms of this request form. You agree your electronic signature is the legal equivalent of your manual signature on this request form. Your Electronic Signature indicates that you are the individual as indicated in this request form and that the use of this electronic request form by any other individual shall be considered fraud and legal action may be taken.
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