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Employee Separation Form

Campus*
Is this an admin staff?
- Yes
- No
Employee Name*
First Last
Last Day Worked:*
Month
Day
Year
Termination Date:*
Month
Day
Year
Unused PTO Hours (to be paid out):
(Eligible unused balance)
Reason for Separation:*
Comments:
Eligible for rehire:*
- Yes
- No
Please provide more details:
Select Ardent property returned by the employee:*
- Polos
- Name Tag
- Keys
- Laptop
- Credit Cards
- N/A
Must be returned no later than last day worked. (Check all that apply)
Select Log-In credentials needing to be removed:*
- Email -or- Email Groups
- Procare
- Raptor
- CRM LineLeader
- Social Media
- Door Codes Reset
- Other
- N/A
(Check all that apply)
Please list any other log-in credentials then need to be removed:*
Which email groups should the user be removed from?*
Have staff been notified of the changes?*
- Yes
- No
Have parents been notified of the changes?*
- Yes
- No
Does the employee need to be blocked from social media?*
- Yes
- No
Upload the Following: Written Resignation, Exit Interview (voluntary termination)
Drop files here or

Max. file size: 8 MB.
* Written Resignation * Exit Interview (if voluntary termination)
Name of person completing this form:*
First Last

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