Employee Separation Form – MCON Management

Employee's Full Name

Supervisor filling out this form

Date of Resignation/Last Day Worked:

How did it become known to you that the employee quit?

Reason for Resignation (if known):

Was a written resignation notice provided?

Did the employee provide notice? If yes, how many weeks/days?

text, resignation how

Check all that apply

Is employee eligible for rehire?

Additional Notes or Concerns:

Please upload any written documentation you have of the separation i.e. text, email, etc.

Click or drag files to this area to upload. You can upload up to 3 files.