Reason for leaving Library Student Employment
(to be filled out by the student employee)

Name _________________________________________

 Unit ______________________________________

 Email Address ______________________ GLADIS/INNOPAC login _________________

 Last date of work ________________________

  • Please number all that apply in order of importance. Put #1 for most important.

  • ______ to devote more time to studies
    ______ parents request
    ______ friendlier work environment
    ______ less stress
    ______ other employment
    ______ higher paying job on campus
    ______ higher paying job off campus
    ______ internship
    ______ withdrawing from school
    ______ graduation from school
    ______ other _________________________________________________
  • This form will help us determine the reasons for the turnover of our student staff. Thank you for your feedback.



  • Reminder:

  • 1. If you have had the DCP and Medicare tax taken from your paycheck, you will need to contact Fidelity at 1-800-343-0860 to have this money refunded to you.
    2. To have your W-2 forwarded to you after you leave, please update your mailing address with LHRD in room 110 Doe.
    3. You may have your last paycheck mailed to you if you leave a self addressed stamped envelope with LHRD or LBS in room 110 Doe.
  • Fold and return this form to Student Employment, Room 110 Doe Library as soon as possible.

  • BY CAMPUS MAIL: Drop in campus mail. No postage necessary
    Address To: Library Human Resources Department
    Attn: Student Employment Coordinator
    110 Library
    m/c 6000

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