NEO A&M COLLEGE EXIT CHECK LIST
Employee: _____________________________________ Termination Date: _______________________
Dept.:__________________________ Supervisor/Dept. Chair/Director: __________________________
This form is to be completed by the separating employee and supervisor, department chair, director or assigned designee prior to an
employee’s departure from NEO. The supervisor should provide this form to the separating employee prior to exiting. In cases where the
separating employee is not able to complete the form, the appropriate supervisor shall ensure its completion and notification of the
appropriate departments. The form shall be submitted to the Human Resource Office upon completion.
AREA/ITEM(S) OF CLEARANCE
(textbook,
instructor’s manuals, teaching aids,
grade books, software, printers, etc.)
Bookstore Manager- Kathryn
Vanover
(Books &
LRC Director- Leslie Hayes
Software, & Related
Equipment
(e.g., Power Supply &
Westphal
(P Card)
Business Office- Gina
Rentfrow or Terry DeCoster
Business Office Cashier-
Crystal Baker
Timesheet/Leave Report
Submitted
(IT ticket)
Terminate access to outside
state affiliations
Termination EPAF
Completed
Employee: ____________________________________________________________________________
Print Signature Date
Supervisor: ___________________________________________________________________________
Print Signature Date
