Employee Resignation From Employment

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@alexander.k12.nc.us
3
Mailing Address or Future Address if moving* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Personal Email Address* This field is required.
example@example.com
5
Phone Number* This field is required.
Please enter a valid phone number.
6
Location of Employment:
7
Position/Job Title:
8
Supervisor Name* This field is required.
Dr. Bill Griffin
Dr. Alisha Cloer
Dr. Amy Bowles
Jessica Anderson
Sharon Mehaffey
Jacob Lail
Cathy Knepp
Kathy Caudle
Danny Stikeleather
Bryan Davis
Joseph Mabry
Brian Lewis
Mary Brown
Dr. Angela Charles
Lee Swanson
Amy Daigle
Stephanie Reep
Jennifer Miller
Dina-Marie Spataro
Andy Palmer
Jessica Mundy
Dawn Leary
Melinda Glenn
Sandra Miller
9
Supervisor Email:
example@alexander.k12.nc.us
10
I wish to resign/retire as an employee of Alexander County Schools, effective at the close of the day on:* This field is required.
Date
Month
Day
Year
11
I will be transferring to the following NC State Agency (if applicable):**IMPORTANT: An employee must notify the employer before leaving employment that he/she is going to work for another state-covered employer at the beginning of the next work year in order to have state health plan coverage for the summer months. For clarification or questions regarding COBRA, supplemental insurance policies, and/or leave balances, contact the benefits specialist in the Finance Department. 828-632-7001
12
Reason for the separation of employment:* This field is required.
Resignation in lieu of dismissal
Resignation
Non-Renewal of Contract
Interim position ended
Dismissed
Retirement
Other
13
Select the best response for why you are resigning/retiring from Alexander County Schools:* This field is required.
Resigning in lieu of dismissal
Failure to obtain/maintain a license
Teach/Work in another NC school district
Teach/Work in education in another state
Moving to a non-teaching position in education
Teach/work in an NC charter school
Teach/work in a non-public school/private school
Family responsibilities/child-care issue
Continue education
Family relocation, and will continue working in education
Family relocation, and will be leaving education
Relocation due to a military order
Dissatisfied with teaching/education
Career change (will no longer work in education)
Health issues or disability
Full retirement
Reduced retirement
Other:
14
How many years have you worked in Alexander County Schools?* This field is required.
15
How many years have you worked in education in NC?* This field is required.
16
How would you rate your employment experience with Alexander County Schools?* This field is required.
1
2
3
4
5
Very Dissatisfied
Very Satisfied
17
How would you rate the quality of leadership and supervision you received from your direct supervisor?* This field is required.
1
2
3
4
5
Very Dissatisfied
Very Satisfied
18
How would you rate the level of support given to you by Alexander County Schools?* This field is required.
1
2
3
4
5
Very Dissatisfied
Very Satisfied
19
How likely are you to recommend or seek a job with Alexander County Schools in the future?* This field is required.
1
2
3
4
5
Very Dissatisfied
Very Satisfied
20
Is there anything Alexander County Schools could have done to prevent your resignation/retirement?
21
What are the strengths of Alexander County Schools?
22
Opportunities for improvement: If you could change anything about Alexander County Schools, what would it be?
23
Do you have any further comments or concerns you would like to share about your employment in Alexander County Schools?
24
Would you like a member of the human resources department to contact you for an exit interview?
Yes
No
25
My signature acknowledges that the information provided is accurate for processing my separation from Alexander County Schools. I have shared my intention with my supervisor and understand that certified positions require a 30-day or 60-day notification period according to my contract.
26
Signature
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27
Date
Date
Month
Day
Year
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