Faculty Notification of Intent to Separate

This form should be completed by the office of the department chair or school dean at the time of notification. 

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 and Learning
  • Human Resources - Benefits
  • Human Resources - Immigration Services
  • Institutional Equity
  • Michigan Tech Research Institute (MTRI)
  • Research and Sponsored Programs
  • Student Records and Registration
Please select the appropriate college dean's office to receive a copy.*



Select separation type.*

For a resignation, an email should be sent directly to Institutional Equity (equity@mtu.edu) with the reason for separation.