23-24 Notice of Separation, Resignation or  Retirement
Please complete this form to provide the District Human Resources office your official written notice of separation of employment.  Your separation will appear on the board personnel report at the next regular board meeting following receipt of this notification.  If any changes are made to your plans, immediately notify Human Resources and your supervisor via email of the change.  If you are retiring and have questions about the date you will retire, please contact Kathleen Long in Human Resources.
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Email *
First Name *
Last Name *
Phone number
Personal email address (non-District)
Type of Separation *
If your separation is a resignation please indicate the reason (i.e. moving, new job, school, etc.)
Please indicate your last day of work. *
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DD
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YYYY
Please indicate your date of separation.  (Usually this is the end of your contract or letter of assignment.  If you opt to retire prior to the end of your contract date, please indicate the date here.)
MM
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DD
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YYYY
If you meet specific criteria related to service years and retirement, you may be eligible to cash out your sick leave balance 1 day for every 4 days available.  You must contact the District payroll office to determine your eligibility and apply to cash out the sick leave before your last day.  If you do not do so you will not be able to cash out later.  Please mark "yes" below to indicate you have read and understand this.
Position type *
Work Location *
Position Title *
Do you wish to work as a substitute after you leave your position? *
A copy of your responses will be emailed to the address you provided.
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