Offboarding Ticket Request

Employee Offboarding request
Name of Requester*

First NameLast Name
Title*
Requester Direct Phone Number*

Area CodePhone Number
Requester Cell Number

Area CodePhone Number
Requester Email*
example@example.com
Name of Employee*

First NameLast Name
Username*
Termination Date*

MonthDayYear
Termination TIme*

:HourMinutesAM/PM Option
Time Zone*
Location*
What groups / access do they need to be removed from?*
Applications to Remove*

Office SuiteTeamsSlackZoomDUO
Any applications to remove not listed above:
Does employee email need to be shared?*

YesNo
If yes, who to share email with:
Date Submitted*

MonthDayYearHourMinutesAM/PM Option
Should be Empty: