Employee Name: _________________________________________Date: ____/____/____ Please print Position:_________________________________ Department: ______________________ Effective Date of Resignation: _____/_____/_____ Reason for Resignation: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Employee signature: ______________________________________Date: ____/____/____ Supervisor signature: ______________________________________Date: ____/____/____ Human Resources signature: ________________________________Date: ____/____/____