FINANCIAL AID SERVICES
700 University Avenue, Monroe, LA 71209
Phone: (318) 342-5320 | Fax: (318) 342-3539
Email: finaid@ulm.edu http://finaid.ulm.edu | URL:
STUDENT WORKER JOB SEPARATION/TERMINATION FORM
Academic Year: Select One: 03 Worker 04 Worker
Student Name: CWID:
Student Job Title: Department:
Supervisor: Supervisor Phone#:
Supervisor Email: Last Date of Employment:
Part I: Type of Separation:
Voluntary Separation: The student has decided to resign from the above position due to the following reason(s):
Position eliminated - Date eliminated:
Student has never shown up for work
Job Dissatisfaction (Attach Resignation Letter)
Found New Campus Job (Attach Resignation Letter)
Other:
Termination: The student has been terminated from the above position due to the following reason(s):
Poor Performance
Behavioral Misconduct
Poor Attendance
Falsification of time worked reported on timesheet
Violation of University Policies
Other:
**Discipline Procedures: In compliance with the termination policies set forth in the Student Employment Manual:
A verbal warning was given Date:
A written warning was issued Date:
Other:
Part II: Signatures:
I/We certify that the terms of this separation/termination of employment have been discussed, the proper steps have been
taken, and appropriate documentation is attached.
Employee Signature: Date:
Supervisor Signature: Date:
Submit original document to: 03 Worker – Human Resources or 04 Worker – Financial Aid Services
