Faculty Notification of Intent to Separate
(Completed by the office of the department chair or school dean at time of notification)

This will initiate a Faculty Exit Survey to be administered by the director of the Center for Teaching, Learning, and Faculty Development.

By submitting this form, a copy will be automatically emailed to the following administrative units for the purpose of ensuring all issues regarding separation are resolved prior to departure:

• Academic Human Resources
• Center for Teaching, Learning, and Faculty Development
• Human Resources - Benefits
• Human Resources - Immigration Services
• Michigan Tech Research Institute (MTRI)
• Research and Sponsored Programs
• Student Records and Registration