To be filled out by employees who are leaving NCI-Frederick - Date 04.20.2015
(Note: this must be completed before the Scientific Library signs off on the Termination Check-Out List)
Please enter the following information. (All fields with * are required)
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If you want to print out a copy of this form for your records press "Print" button
Submit or return to the Scientific Library, Building # 549 prior to your last day of employment.