BSD Resignation Form – Bethel School District

Date

Name

First

Last

School/Department School/Department

I am voluntarily resigning my position from Bethel School District.

Yes

No

My last day of work will be: (Licensed staff see note below.)

My reason(s) for leaving is:

I request an Exit Interview with Human Resources:

Yes

No

Last Check and Payout:

I request my last check and payout of any accrued leave owed to me be in the form of a direct deposit on the next regularly scheduled and available payday.

I request my last check and payout of any accrued leave owed to me be in the form of a paper check that will be mailed to the address on file with the District.

By completing and submitting this resignation form, I understand it is my responsibility to return all school and district property including, but not limited to technology, curriculum, tools, keys and other equipment or items by the end of the last day of work.

NOTE: Oregon Revised Statute 342.553, Discipline for resigning without providing required notice, requires 60 days’ written notice for licensed staff.

Supervisor Name

First

Last

Type your name below to confirm you wish to submit your resignation.

Email