Termination Request Form – MCON Management

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MANAGERS

Terminations should not be finalized or communicated to the employee without prior approval. This form will go to HR and any necessary management for review and discussion.

Thank you for adhering to this protocol to ensure a fair and consistent process across the organization.

Date *

Employee to be terminated: *

Company *

Southam
Ram
Uneeke
Fluid Dynamics
MCON

Supervisor requesting the termination: *

How long has the employee worked for the company (approximately)? *

Reason(s) for termination (check all that apply) *

Job Abandonment
Attendance
Tardiness
Performance
Violation of drug and alcohol policy
Failure to follow procedure
Reduction in force
Dishonesty
Time Card Fraud
Damage or misuse of company property
Theft
Misconduct or violation of Standard of Conduct policy
Other (describe in additional comments)

Is the foreman, crew leader, and super aware of this termination request? *

Person filling out this form, if different from the supervisor

If the employee is being terminated for any reason other than "reduction in force", has the employee had any verbal or written warnings regarding the behavior prompting the termination? *

Yes
No
Unsure
N/A (reduction in force)

Please describe in additional comments section below

Do foresee any unusual problems with this employee once they are terminated that we need to be aware of? *

Yes
No
Unsure

If you answer yes, please describe in additional comments section below:

Additional Comments: *

Please include screenshots of warnings, etc. here:

Click or drag files to this area to upload. You can upload up to 10 files.

Signature of supervisor *

Clear Signature

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