LOS ANGELES UNIFIED SCHOOL DISTRICT
Electronic Form

Request a Certificate

 
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 Request a Certificate 

 
  Please fill out the information below for your certificate request and please allow 2 weeks for process.
   
1.
*
The value must be between 07/01/2015 and 06/30/2025, inclusive.
  Select Date
mm/dd/yyyy
   
2.
*
(First and Last)
 
   
3.
*
(First and Last)
 
   
4.
*
 
   
5.
*
 
   
6.
*
The value must be between 07/01/2015 and 06/30/2025, inclusive.
  Select Date
mm/dd/yyyy
   
7.
*
Select at least 1.
 
  
  
  
  
  

    
   
8.
*
The value must be between 07/01/2015 and 06/30/2025, inclusive.
  Select Date
mm/dd/yyyy
   
9.
*
 
*



   
10.
 
   
 
 
 
 Done  Cancel