EmailMeForm
Program Coordinator Resignation
Fill out this form if you wish to sever all employment with Zumbro House.
*If you are a current employee who wishes to transfer to another position within Zumbro House, please fill out the Transfer Request Form.
Please contact your supervisor via phone to inform them of your resignation.
Who is completing this form:
Employee (Self)
Supervisor (or other) on behalf of employee
If you are not the employee, please list your name below, and relationship to the person resigning:
Name of employee resigning:
*
Today's Date
*
MM
/
DD
/
YYYY
Two weeks notice given:
Yes
No
Location/Department of current position or float:
*
Hours currently worked:
*
Please state last day available to work in current position (we require a two week notice if you wish to be considered for rehire)
*
MM
/
DD
/
YYYY
Reason for Resignation
*
Signature of employee resigning or signature of person completing this form on behalf of the employee:
Clear
