Termination

CHANGE OF STATUS FORM

Employee Name *

(First/Last)

Last Day Worked *

mm/dd/yyyy

Is the employee eligible for rehire? *

Yes

No

Was the termination voluntary? *

Yes

No

Reason for Term: *

Abandoned Job

Advancement

Attendance

Compensation

Layoff

Management

Misconduct

Mutual Agreement

No Show

Performance

Personal Reasons

Termination Checklist *

Toast POS

7shifts

Slack

Manager Applicable Items:

Keys Returned

Email Cancel/Forward

DiskStation

Insurance

Cobra

Verified by Supervisor: *

Type to search

*

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