Office of Student Employment
 
Form is Secure
TERMINATION FORM FEDERAL WORK STUDY PROGRAM
 
Please fill out this form to terminate a work-study student.
 
Please review our privacy statement relating to information we collect, choice/opt-out, and correction/updating of personal information before proceeding.
 

* Student Employee
 
 
* UM ID
 
 
* Department Name
 
 
* Position #
 
 
* Supervisor
 
 
* Job Title
 
 
* Total Amount Earned by Student
  (Total Amt. earned by student under this assignment)
 
 
* Last Day of employment
  (Must be the last day of a pay period)
 
 
* Reason for Termination
 
 
* Date
 
 
Name of Department Head
  (if applicable)
 
 
* Address & Phone Number