Termination Form – Southam and Associates

Date *

Employee to be terminated: *

Company *

Ram Exteriors
Southam and Associates
Uneeke Manufacturing
Fluid Dynamics

How long has the employee worked for the company (approximately)? * *

Supervisor requesting the termination: *

Is the foreman, crew leader, and super aware of this termination request? *

Yes
No

Person filling out this form, if different from the supervisor

Reason(s) for termination (check all that apply) *

If the employee is being terminated for any reason other than "reduction in force", has the employee had any verbal or written warnings regarding the behavior prompting the termination? *

Yes
No
Unsure
N/A (reduction in force)

Please describe in additional comments section below

Do foresee any unusual problems with this employee once they are terminated that we need to be aware of? *

Yes
No
Unsure

Please describe in additional comments section below

Additional Comments: *

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Termination Request