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Notification of Student Worker/Work Study Resignation/Termination Form
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* Indicates required question
Date Submitted:
MM
/
DD
/
YYYY
Student Name:
*
Your answer
Student Colleague Number
*
Your answer
Please check one:
*
Student Worker
Federal Work Study Student
Required
Please Check one:
*
Voluntary
Involuntary
Other:
Required
Last Day Worked:
*
MM
/
DD
/
YYYY
Submitted By:
*
Your answer
Department
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Math/Science & Health Professions
Business & Technology
Child Development Center
Financial Aid
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Library
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Corporate & Community Education
Small Business Development Center
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Hoopeston Extension
Instructional Media
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