Loudoun - Employee Exit Form

NPS

2.
Employee Exit Information Form

Please provide the following personal information:

First Name *Required

Last Name *Required

Employee ID #

Personal Phone #
(Format: 123-456-7890 or 123 456 7890) *Required

Personal Email Address
(Format: name@online.com) *Required This question requires a valid email address.

Work Email Address
(Format: name@online.com) *Required This question requires a valid email address.

Department

Other Department:

Manager

Last Day of Work *Required This question requires a valid date format of MM/DD/YYYY.

calendar

Any Questions?

Policy & Process related questions:
Geneva Douglas, Employee Relations Manager - geneva.douglas@loudoun.gov
Judy Kwitnieski, Learning and Organizational Development - judy.kwitnieski@loudoun.gov
or any member of the Employee Relations, Learning and Organizational Development team

Technical and Systems related questions:
Flex Surveys - loudoun@flexsurveys.com or toll-free at 1-877-327-5058

Loudoun - Employee Exit Form - 2023

Loudoun - Employee Exit Form - 2023

NPS