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Terminate or Exit Employment

Complete this form to terminate or resign from a PICS employment position.

Please allow 48 hours for processing.

My first name

My last name

My title at PICS

Representative

Worker

Representative and Worker

Name of Worker ending employment

Reason for ending employment

Worker resigned

Representative terminated employment

Hiring process terminated

Non-compliance with employment requirements

Participant's services with PICS ended

Participant's services no longer require staffing

Termination or resignation effective date

If terminated, please state reason why

Did you receive or provide proper notice of the termination or resignation?

Yes

PICS | 1605 Eustis Street, Saint Paul, MN 55108 | 888.874.7427 | Contact Us