Employee Deactivation Form

Complete from to deactivate employee accounts
Requester Name *

First NameLast Name
Requester Email *
example@example.com
Employee Details

Please enter details about the Employee and Role in the organization
Name*

First NameLast Name
Effective Date: *

MonthDayYear
Date
Department: *
Department he/she will be joining
Role
Job Title: *
Official Title they were offered when hired
Province: *
Desk Location: *
Work Station Returned
Workstation Returned: *
Note 4 weeks lead time for new workstation
Windows AccountEmail AddressASSI VPN (On Demand Only)
CROMS OntarioUATProductionCROMS Ontario - MobileUATProductionCROMS NSUATProductionCROMS AlbertaUATProductionCROMS PEIUATProduction
Company Mobile? *
Does the role include a company Mobile Phone.
Any Other Requirements
Managers Details

New Employee Managers details
Manager's Name

First NameLast Name
Province:
Manager Email
example@example.com
Should be Empty:

Employee Deactivation Form

Employee Details