Resignation Notification Form

Are you completing this form on behalf of your employee leaving? *

Have you received a written resignation? *

Employee Name: *

Employee ID *

Employee Email *

Personal email is requested, to enable contact after separation.

Employee Business Title *

Last Day To Work (Faculty Only: include last date worked and retirement date): *

Employee may not use leave after the last day worked.

In which VP Area does the employee work? *

Department Name *

Supervisor Name *

Supervisor Email *

Primary Reason for Resignation *

Type of New Employer *

Name of Idaho State Agency *

Transfer Date *

Have you ever been or are you currently involved in research while employed at Boise State? *

Do you have open protocols with any of the following committees (check all that apply)? *

Do you have a project (grant or contract) funded either internally or by an external sponsor? *

Do you have any invention disclosures, patents or other intellectual property being marketed or licensed through Boise State? *

Notification Form