Exit Employment Verification Form Question Title * 1. Employee name: Question Title * 2. Name of your organization: Question Title * 3. Name of person completing this form: Question Title * 4. Email of person completing this form: Question Title * 5. Phone number of person completing this form: Employee information Question Title * 6. Is this person currently employed at your organization? Yes No Question Title * 7. Employment start date: Date Date Question Title * 8. Employment end date (if not currently employed): Date Date Question Title * 9. Job title: Question Title * 10. Is this person eligible for rehire? Yes No Done