Offboard Form

Your Name (required)

Your Email (required)

Employee Information

Employee Name*

Employee NetID*

Termination Date*
(for browsers without a date picker, enter: YYYY-MM-DD)

Employee's Unit*

Academic Services & FacilitiesEnvironmental Health & SafetyHealth Sciences AdministrationOffice of Animal WelfareWashington National Primate Research Center

Employee's Job Title*

Is this employee leaving the University?*
YesNo

Supervisor's Information

Supervisor's Name*

Supervisor's Email*

Supervisor's Phone Number*

System Access

Date to Shut off Access (If Different than Termination Date)
(for browsers without a date picker, enter: YYYY-MM-DD)

Please indicate which systems the employee had access to that need to be removed:
eProcurementeReiumbursmenteTravelMyFinancial.desktopSystem to Administer Grants Electronically (SAGE)Purchase PathGrant and Contract Certification Report (GCCR)Center for Shared Services Sharepoint/Website Access
Other Systems:

Job Duties

Did this employee supervise anyone?*
YesNo
Did this employee approve any purchasing in PurchasePath?*
YesNo
Did this employee have a ProCard?*
YesNo

Additional Comments: