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Student Employment Termination Form
  • To be filled out by the department terminating employment.
  • All fields are required except:
    • Departmental Feedback
    • Type of Work Student Performed
    • Quality/Quantity of Work Performed

Student's First Name 
Student's Last Name 
Student's SID 
Type of Employment
Index Number 
Account Number 
Last Day Worked 
Eligible for Re-Hire
Reason for Termination
Examples: Graduated, gone for summer, found other employment, no longer a full time student.
Supervisor's Name 
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Employee SID