Intent to Leave Form

We are sorry to see you go! We thank you for your employment and wish you all the best in your endeavors.

Name*
First Last
Company*
EJ Department*
MJ Department
EJC Location
EJPPG Department
What date would you like to request to be your last day?*
MM slash DD slash YYYY

*Please note: To be eligible for rehire, you must complete a two-week notice, and management reserves the right to pick your last day.
Reason you are leaving*
Where?
Other reason
If you took another job, what is your new employer offering you that we do not?
Was there anything that we could have done for you to remain employed here?
Email Address (This is where our employment exit survey will be sent)*
Click that you have read this statement:*
I am hereby giving notice to terminate my employment and agree to complete my two-week notice. I understand that, if I do not uphold the completion of my notice, I will not be eligible for rehire for two years.
Type legal name below as digital signature*
First Last
This field is hidden when viewing the form
By signing this form, I am hereby giving notice to terminate my employment and agree to complete my two-week notice. I understand that, if I do not uphold the completion of my notice, I will not be eligible for rehire for two years.