CON Request to Terminate Form
Form Completed By
Supervisor Name
First Name
Last Name
Supervisor Email
example@example.com
Employee Name
Email Address
End Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Day Worked (if taking leave prior to end date)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Is the terminating employee a supervisor?
Please Select
Yes
No
Termination Reason
Is the terminating employee transferring to another UA department/college?
Please Select
Yes
No
Please attach Resignation Letter/Notice
Browse Files
Cancel
of
Additional information, comments or questions
Submit
Should be Empty: