Exit Interview – Courthouse Employees

Choose Type

Exit Employee

Employee Name*

First Last

Employee Email*

Employee Phone*

Position Employee is Leaving*

Is the employee leaving ALL positions at Courthouse*

Yes
No

Club Assignment*

Reason for leaving*

Keys Returned*

Yes
No
None Issued

Key Number

Final Check - How would the employee like to receive their final check.*

Mail Final Check - check will be processed & mailed within 48 hours (Please approve employee's timecard)
Process with next payroll (including direct deposit)
Check was already delivered
Other (please be specific with directions in additional information)

Last Day Worked (If employee wants check processed with next payroll, last day work is the 5th of the following month.)*

Forwarding Address for Final Check and W-2*

Street Address City State / Province / Region ZIP / Postal Code

Membership*

Terminate Membership
Employee would like to continue membership and I have processed employee's request in Compete (and collected a signature on a new agreement)

Membership will automatically be cancelled at the end of the current month. If employee would like to continue membership, please sell them the correct agreement. Please check with employee and what they would like to do with any kids or add on individuals

Additional Information

Please include if the employee has a locker, would like to keep any additional programs/services. Does the employee have anything addition to say about Courthouse Fitness?

I hearby verify that the above items were covered with me at the time of my departure as an employee of Courthouse Athletic Club*

Yes
No
Left without notice

Inactive Employee

This form is to be used if an employee will not be working for at least one month or more, but will be returning. Examples are: Maternity Leave, going to school but helping sub when back in town, etc. Please make sure to communicate to the staff member that because they are not meeting the minimum shift requirement while they are gone, they are no longer eligible for Employee Benefits discounts and free membership until they return.

Employee Name

First Last

Employee Email*

Employee Phone*

Position Employee Will Be Inactive From*

Club Assignment

Reason For Being Inactive

Expected Return Date If Known

Inactive Date*

Membership*

Terminate Membership
Employee would like to continue membership and I have processed employee's request in Compete (and collected a signature on a new agreement)

Membership will automatically be cancelled at the end of the current month. If employee would like to continue membership, please sell them the correct agreement. Please check with employee and what they would like to do with any kids or add on individuals

Additional Information

I have communicated the above information to the staff member

Yes
No

Name of Person Filling Out Form*

First Last

Date

Forms > Exit Interview

Exit Employee

Inactive Employee