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Employee Portal
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Now Hiring
Contact Us
Employee Portal
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Employee's Full Name
*
email, Worked: Notes
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):
*
Job Offer Elsewhere
Personal Reasons
Relocation
Dissatisfaction with Job/Company
No Notice Given (Job Abandonment)
Other
Was a written resignation notice provided?
*
Yes (Attach copy)
No
Did the employee provide notice? If yes, how many weeks/days?
*
Check all that apply
Tools were returned, if applicable
Credit Card
Laptop
iPad
Phone
Company Vehicle
Key Fob
Is employee eligible for rehire?
*
Yes
No
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.
Submit
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