Seasonal Employment Separation Form

Seasonal Employment Separation Form
Employee Name*

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

Activities RecAttendant RRClubhouse LSConc/Cashier HRConc/Cashier RRCourse Supervisor LSGuard 1 RRGuard 2 RRMaintenance HRMaintenance LSMaintenance RRManager HRManager LSManager RecMechanic HRPool Manager RRState Events
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: