Group Exit Notification Form
Notify us when a group is leaving or ending participation. Please complete all relevant details to help us process your notification efficiently.
Group Name
*
Notifier's Full Name
*
First Name
Last Name
Notifier's Email Address
*
example@example.com
Notifier's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Exit Effective Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Exit
*
Please Select
Completed objectives
Change in priorities
Resource constraints
Leadership decision
Other
Number of Members Affected
*
List Member Names or Identifiers
Is this exit final or temporary?
*
Final
Temporary
Outstanding Items or Handover Notes
Preferred Method for Follow-Up Contact
*
Email
Phone
No follow-up needed
Submit Notification
Should be Empty: