HR Office Use Only Form H – Rev 11.13.14 _____ Employee _____ Cust Mgr _____ Principal _____ CTE Coord _____ BT Coord _____ Dir/Media Letter of Resignation _____ Dir/EC _____ Dir/Title I _____ Dir/ESOL _____ Dir/SFS _____ Dir/Elem _____ Dir/Tech _____ Dir/Middle _____ Dir/Maint _____ Dir/High _____ Dir/Trans _____ Retirement ______Employee Completes: ______Personnel File
______Name______Last 4 digits of SS#______Signature Date
Home Address______
Site______Present Position______
I hereby tender my resignation in the Rowan-Salisbury School System to take effect at the close of the day on______
My reasons for resigning – (Check one): _____Retirement _____Teach in NC charter school _____Interim/Temporary assignment ended _____Re-Employed retiree resigned _____Teach in private school _____Continuing education _____Family obligations _____Teach in another state _____Personal reasons _____Health reasons _____Moving out of the area _____Changing profession _____Dissatisfied with job _____Position ended _____Did not maintain educator’s license _____Transferring to another NC school system or state agency-(name of system)______Other(please indicate) - ______
Additional comments______If moving from address given above, please list the future or permanent address where mail may be forwarded to you and the date you plan to move. Your TAX FORMS will be mailed to this address, unless otherwise notified.
Street Address City State Zip Moving Date
Please include personal email address for link to participate in exit survey______
I understand that my final paycheck will be direct deposited.
Employee’s Signature______Date______Please present this form to the principal or site supervisor to whom you are assigned.
Principal/Site Supervisor Completes: I acknowledge this resignation with the understanding that his/her last day on payroll will be ______
I request advertisement of this position Yes No Employee Code
Please describe how you would like the vacancy to be listed______
Supervisor’s Signature______Date______Fax/Scan this form to the HR Specialist at the Ellis St. office. Fax # 704-639-3179
Director’s Signature______Date______
For Human Resources Office Use Only Last day on payroll______
HR Specialist______Date______
Executive Dir of HR______Date______