Requests Retirement Certificate - District Staff Please submit this form if you want the Board District 3 office to prepare a certificate for district staff. Important:Please allow at least 2 weeks for processing of the requestRetiree Name* Please submit the retiree's name as you want it displayed.Pronoun*SheHeTheyPlease provide the pronoun this person prefersYears of Service* How many years has this person worked for LAUSD?Titles and Positions*Please list the Job Titles the person has had and the school site, if applicableRetirement Date* MM slash DD slash YYYY Please provide the date when the person will retire or that you would like displayed on the certificate.Due Date* MM slash DD slash YYYY Please provide the date when the certificate should be ready.Special Qualities, Outstanding Achievements, Award*Please describe the qualities that this person had that they will be remembered by, any of their outstanding achievements or any important awards they received.Submitted by* Please include the name of the person submitting the request.Email* Phone* Recognition Certificate - Community Please fill out this form to request a certificate for a community member that deserves recognition. Important:Please allow at least 2 weeks for processing of the request.Complete Name of Person, School or Organization receiving Certificate* Please provide the name of the person as you want it displayed on the certificateReason for Recognition*Please provide the reason why this person is being recognizedSchool Name Please provide the name of the school with whom this person is associatedDate on Certificate* Please provide the date that you would like to see on the certificate.Due Date* MM slash DD slash YYYY Please provide the date when the certificate should be ready. Submitted by:* Please include the name of the person submitting the request.Email* Phone*