Seasonal Employment Separation Form

Seasonal Employment Separation Form
Employee Name*

First NameLast Name
Department*
Position (select all that apply)*

Activities C2Activities RecAsst Supervisor HRAsst Supervisor SoccerCashier HRCashier RRClubhouse LSClubhouse Supervisor LSConcessions HRConcessions Mgr HRConcessions RRCourse Supervisor LSGuard 1 RRGuard 2 RRGuard 3 RRMaint Supervisor RRMaintenance 1 HRMaintenance 1 RRMaintenance 2 HRMaintenance 2 RRMaintenance LSMechanic HROfficial RecOuting Manager LSPool CoordinatorPool Manager RRShift Manager LSState EventsStreetscapeSupervisor C2Supervisor Rec
Position (select all that apply)*

Maintenance ForestryMaintenance OakMaintenance ParksMaintenance ROWSeasonal LaborerCompost Site Attendant
Position (select all that apply)*

Seasonal LaborerCompost Site Attendant
Separation Date*

MonthDayYear
Date
Last Day Worked (if different)

MonthDayYear
Date
Reason for Separation*

VoluntaryInvoluntaryInvoluntary - End of Season
Additional Comments
Supporting Documentation (if any)

Cancelof
Eligible for Rehire*

YesNo
Supervisor Completing Form*

First NameLast Name
Supervisor's Email*
example@example.com
Should be Empty: