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