Resignation and Exit Form

Resignation and Exit Form
- All questions marked with an *asterisk are required.
- Please note that your final pay will be electronically deposited into the account on file.
- ** An individual’s network account, including email, will be disabled the day following the employee’s last day of employment. If the employee has any personal electronic records or Evaluations from Eduphoria, they need to make copies of them before their account is disabled.
Submission Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Employee Number*
Full Name*

First NameLast Name
Personal (non-district) E-mail Address
example@example.com
Location*
Position*
Specify assignment*
Principal/Immediate Supervisor*
Has principal/supervisor been notified?*

YesNo
Last Day to Work*

MonthDayYear
Have you or will you be applying for a summer school position?*

YesNo
Reason for leaving Goose Creek CISD. (Check all applicable)*

MovingHealth ReasonsContinuing EducationFamily CircumstancesDissatisfied with Type of WorkDissatisfied with SupervisorNeighboring District/Closer to HomeNeighboring District/More MoneyNeighboring District/PromotionLeaving ProfessionNon District Employer/More MoneyNon District Employer/Closer to HomePersonalOther

How would you rate your experience in Goose Creek CISD in regard to the following?*

	Excellent	Good	Fair	Poor
Working relationship with your supervisor
Adequacy of job orientation and training
Evaluation procedure
Employment benefits
Communication within the district
Overall experience with Goose Creek CISD

OFFICE USE ONLY:

□ Principal/Supervisor Notified
□ Sent to Registration Group
□ Separated

□ Board Meeting Date
________________________
□ Sent Letter of Acceptance

□ APPROVED
□ NOT APPROVED

Signature:
________________________