Employee Termination Notice
Requested By:
*
Program:
*
Please Select
Safe Haven
Central Office
Head Start
Housing
Nutrition
RSVP
SW Enterprises
SW Transit
TSET
Employee Name:
*
First Name
Last Name
Last Day of Employment:
*
-
Month
-
Day
Year
Date Picker Icon
Termination Type:
*
Please Select
Voluntary
Involuntary
Uncontrollable
Termination Reason: (please check all that apply)
*
BENEFITS (Took job with better benefits)
CAREER CHANGE (Changing Career)
CAUSE (Terminated with Cause)
DISABILITY (Became disabled)
FAMILY HEALTH (Family Member's Health)
HEALTH (Health Reasons)
HOURS (Took job with more hours or better schedule)
JOB CHANGE (Took another job)
MOVE (Employee relocated out of area)
PAY (Took job with more pay)
PERSONAL (Personal Reasons)
RETIREMENT (Retired)
TEMPORARY (Temporary Position Ended)
UNKNOWN (No reason given)
Other
Would you recommend this employee as eligible for rehire?
Yes
No
Special Instructions OR Additional Comments:
Submit to Human Resources
Should be Empty: