Notice of Voluntary Separation Form

Instructions for supervisors
  1. Complete and submit this form within 24 hours of receiving notification of resignation or retirement.
  2. For retirements, contact Kim Howard (x5432) to ensure the Personnel Action Form (PAF) has been created.
  3. For voluntary resignations, complete the (PAF); attach the resignation letter to the PAF and circulate it for appropriate signatures.
  4. Direct questions to either Karen Hinton (x4801) or Mildred Singleton (x4631).




The employee was on leave before giving notice and/or separation of employment.



The employee gave required notice:
(a minimum of two weeks or per the terms of the employment agreement/contract).

To your knowledge, is the employee a student or employed in another position at CCBC?


Please note: Once this form is submitted it will be electronically distributed to the following departments:
  • Campus Directors
  • Human Resources 
  • Information Technology 
  • Payroll 
  • Public Safety 
  • Purchasing