Summary: HOW TO COMPLETE THE REQUEST FOR RECORD OF EMPLOYMENT FORM
This form is to be used when an employee requires a Record of Employment (ROE) from Human Resources when a break in service
has or is going to occur.
When a break in service is going to occur at a future date then the Request Form can be completed and submitted to Human Resources
in advance. The individual would then request that the ROE be available for pick up on the individual's last day of employment with
Submit form to:
Fleming Hall, Stewart-Pollock Wing
This form is an interactive Adobe document. Once completed, print then submit (send) the document to Human Resources for action.
1. Insert the cursor into the first field (Name)
1. Record your last name and first name.
2. Record your employee number and your Social Insurance Number (Note this is required data, if employee number is
unknown contact Human Resources at extension 32070)
3. Record your home address.
ROE previously issued:
If an ROE has been previously issued by Queen's University for a previously worked term of employment, then only the
information relating to the current term of employment is required.