Maricopa Community Colleges

Departing Employee Form

This form may be completed or submitted by the ITS liaison or by employee's Supervisor.

Departing Employee Information

(Inaccurate information may result in delay of service)

Employee's Full Name:	(required)
Date Of Departure:	(MM/DD/YY)
Time Of Departure:
Email Address:	(required)
Department:	(required)
Extension:
Office Location:

Supervisor's Information

(Supervisor Information Is Required)

Supervisor's Name:
Supervisor's E-mail:	(DO MEMO address)
Supervisor's Extension:

Accounts to be terminated:

(Check All That Apply)

E-mail account - MEMO
Corporate Time - Calendar
CFS - College Financials System
Human Resources (Peoplesoft)
Student Information System - SIS (District Office)
BDS - Budget Development System (Peoplesoft)
VPN - Remote Access Account
Network Access (Workstation Login)
Additional Comments:

Computer/Desktop Deletions

If the departing employee's computer is to be deployed to another employee already employed by Maricopa then a separate Computer Setup Form needs to be filled out and submitted.

If the computer is being deployed to a employee new to Maricopa then a New Employee Setup Form will need to be filled out and submitted.

Telephone Terminations

Voice Mail Box
Long Distance Access Code
Additional Comments:

Building Security Services

Please turn in all badges, keys, and vehicle parking permits to Roberto Isaac.
The following item(s) will be turned in to Security:
ID Badge
Card Keys
Door Keys

Building Services

Would you like the mailroom to be notified of this change in status?

Property Inventory

Does this employee have any software or hardware belonging to MCCCD?
If so, please list item(s):

Additional Notes and Comments

Is there any information or comments you would like to include with this deletion of employee's accounts & services?

If a copy of this form and the information entered needs to be retained. Please press the print key, located at the top of the browser window, before clicking the submit button.