Voluntary Termination of Employment Notification

To be completed by the supervisor or department manager.

Directions:

Enter the employees name, WesID, you name and phone extension, last day worked, reason for seperation, number of vacation days or hours remaining, and their new address if applicable.
After completing the form, it is important to click the "Submit" button to send this information to Human Resources.

Requested By:
Employee Name:
Supervisor Name:
Supervisor Extension:
Last Day Worked (mm/dd/yyyy):
Reason for Termination:
Vacation Payout
Please review and verify the employee’s current vacation balance in your manager’s toolbox. Please contact HR to correct any discrepancies before submitting this form. If the employee’s vacation balance changes before the employee’s last day worked, email the corrected total to Human Resources.
Amount of Unused Vacation:
Increment for Unused Vacation:	DaysHours

Wesleyan Account
Employee accounts will be deactivated upon the date of termination. Please arrange with the employee the transfer of shared files and emails prior to their last day.

Special Instructions: