Student Employment Change Form Name* First M.I. Last Student ID Number*Supervisor Name*Change of Employment*Change of class rankInactiveTermination/ResignationChange of Class RankNew class rank*SophomoreJuniorSeniorEffective date* Date Format: MM slash DD slash YYYY Termination/ResignationReason for ResignationDisliked the jobGraduationFound other jobResigned / unknownWalked off jobLeft SchoolEnd of SemesterDepleted Work Study FundsReason for TerminationAttendanceRestricted DutyDeathDrug-relatedReorganizationInsubordinationTheftConflict of interestTimecard MisusePoor PerformanceLegalLast Day of Employment* Date Format: MM slash DD slash YYYY Rehire Eligible*YesNoComments