Departure Form

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Departure Form

First/Given Name *

Last/Family Name *

Last Semester Enrolled in UW-Madison *

List Semester and Year (e.g. Spring 2015)

Office

Please clean out your office space and mailbox before you leave

Office Number *

If you do not have an office. please indicate n/a in the following two spaces.

Anticipated date you will vacate your office. *

We encourage you to vacate by June 15th, if possible. New hires will begin arriving in June.

Math Department accounts typically expire in October and March. If you graduate in May, you'll be told you have until October to get settled in your new situation. If you want a 6-month extension, you'll need to contact nagreen@math.wisc.edu.

The UW's netid@wisc.edu emails typically will expire in a 3-4 month timeframe.

What was your Math Department login id?

Would you like help backing up your email?

Yes

Clear selection

Would you like help in backing up your files on the server?

Yes

Clear selection

Would you like to have your email forwarded to another account? If so, provide it below.

Please be aware that we may not be able to maintain a forward for more than a few months due to changes in email infrastructure.

Would you like to have your webpage forwarded? If so, provide it below.

Please be aware that this is a temporary forward, and will not be maintained indefinitely.

Are there other IT related questions you'd like answered?

Where can you be reached before your arrival at your next destination?

For mail forwarding purposes.

Address *

Street, City, State, Zip

Email *

Non-UW

Phone *

Highest Level of Degree *

MA or PhD

PhD

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