Exit Interview
Employee Exit Interview
(To be filled out by Employee)
Date: _________________
Name: ____________________________ Job Title: ________________________
Supervisor: _________________________ Length of Employment: _______________
1. What are your reasons for leaving? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2. Would you describe your working relationship (with respect to both your particular job and your relationship with fellow workers) as pleasant or unpleasant?
_________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
3. Are there any particular practices or working conditions that either led to your decision to resign or that you feel are detrimental to a satisfactory working relationship? If so, have you any suggestions on how to eliminate them?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
4. Are there any particular practices or working conditions that you feel are particularly beneficial to an effective working relationship and that should be maintained?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
5. How would you rate your supervisor?
Excellent Good Average Fair Poor
5 4 3 2 1
6. Did you feel you were reimbursed (paid) adequately and fairly?
Excellent Good Average Fair Poor
5 4 3 2 1
7. How would you rate the training and inservicing you received here?
Excellent Good Average Fair Poor
5 4 3 2 1
8. How did you feel about your hours of work?
Excellent Good Average Fair Poor
5 4 3 2 1
9. How did management resolve any grievances you might have had?
Excellent Good Average Fair Poor
5 4 3 2 1
10. Would you care to make any other comments?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
11. Your forwarding address: ____________________________________________
__________________________________________________________________
Signed: _________________________________ Date: _____________________
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