Resignation/Final Employment Date

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Full Legal Name: *

Which company would you like to resign from? *

ARCC Center Foundation ( Respite)

ARCC Center ABA (ABA Therapy)

Both: ARCC Center Foundation (Respite) & ARCC Center ABA ( ABA Therapy)

Date and time of your last session - Include Client(s) first/last name *

Ex- John Smith - 9/15/24, 5-9pm.

Final Date of Employment *

YYYY

Mailing Address for your Final Check *

Clients you are working with and/or Set Schedules (include specific days/times, special instructions) *

Ex- I work with Client A on Tuesdays/Thursdays from 12pm-6pm, Client A has 2 younger siblings. I work with Client B every other Saturday from 5-10pm and I schedule directly with Client C, Client D and Client E.

If you have other information that we need to know about, please add below.

Reason for leaving *

If you plan on returning during a school break please mark the following

Yes

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