I hereby submit my formal application for participation in the East Buchanan Community School District’s Retirement Program.
As part of my application I will, by February 28, 2024, submit a resignation from my contract with the Board which will be effective at the end of my current contract. It is my understanding that this application and my Resignation will be acted upon simultaneously by the Board of Education.
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Employee Signature Date
Application received by the Board of Education on , 20 .
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Board Secretary Date
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Resignation received by the Board of Education on , 20 .
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Board Secretary Date
Resignation accepted and Retirement Program Participant approved by the Board of Education on
, 20 .
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Board Secretary Date