UNIVERSITY OF WYOMING



|Name: | |

UNIVERSITY OF WYOMING

HUMAN RESOURCES DEPARTMENT

CONFIDENTIAL

Exit Interview Questionnaire

The University of Wyoming recognizes employees as its most important asset. The Employee Relations staff members are committed to creating and maintaining a positive work environment for all members of the UW community. Your experience as an employee will provide us with valuable information for recruiting and retaining employees and improving the overall work environment.

Please be as candid and complete as possible. Please be assured that this questionnaire will not become part of your personnel file and your comments will not affect your re-employment possibilities should you desire to seek employment again with the University of Wyoming.

Reasons for Leaving

Was your decision to leave the University influenced by any of the following? Please indicate those applicable by "X" and rank 1st, 2nd, 3rd.

| |Continuing my education | |Lack of funds |

| |Moving from the area | |Type of work |

| |Health reasons | |Working conditions |

| |Retirement | |Supervision received |

| |Family circumstances | |Fringe benefits |

| |Secured a better job | |Salary |

| |Lack of opportunities to advance | |Discharged |

COMMENTS:

| |

Working Conditions and Benefits

What is your opinion of the following:

| |Excellent | |Good | |Fair | |Poor |

|Your Salary | | | | | | | |

|Retirement Plans | | | | | | | |

|Health and Dental Insurance | | | | | | | |

|Performance Evaluation Practices | | | | | | | |

|Physical Working Conditions | | | | | | | |

|Opportunity for Advancement | | | | | | | |

|Paid Time Off | | | | | | | |

|Workplace Culture | | | | | | | |

COMMENTS:

| |

Communication, Guidelines, and Practices

How would you rate the following in your department and the University in general?

| |Excellent | |Good | |Fair | |Poor |

|Communication regarding university guidelines and | | | | | | | |

|policies | | | | | | | |

|Communication regarding department guidelines and | | | | | | | |

|policies | | | | | | | |

|Salary increase practices | | | | | | | |

|Orientation: | | | | | | | |

|to your job | | | | | | | |

|to the University | | | | | | | |

|Communication: | | | | | | | |

|With your supervisor | | | | | | | |

|With your co-workers | | | | | | | |

COMMENTS:

| |

Supervision

How would you rate your immediate supervisor on the following topics?

|Supervisor's Name: | |

| |Excellent | |Good | |Fair | |Poor |

|Training and opportunities to learn | | | | | | | |

|Gives positive feedback and recognition | | | | | | | |

|Resolves complaints and grievances | | | | | | | |

|Welcomes suggestions; solicits input | | | | | | | |

|Develops cooperation and teamwork | | | | | | | |

|Gives clear instructions | | | | | | | |

|Provides opportunities to do challenging work | | | | | | | |

|Follows consistent application of policies | | | | | | | |

Assigns reasonable workload ____________ _________ ________ _______

Respectful toward employees ____________ _________ ________ _______

COMMENTS:

| | | |

|Name: | | |

UNIVERSITY OF WYOMING

HUMAN RESOURCES DEPARTMENT

CONFIDENTIAL

Exit Interview Questionnaire

1. If you are going to a different job, what does it offer that the one here did not?

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2. What were the factors that contributed to your initially accepting a job at the University?

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a) Were your expectations realized?

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b) Has the job changed?

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3. What constructive comments would you have for management in regard to making this a better place to work?

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4. What are some of the factors that have contributed to making your employment enjoyable?

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5. Would you recommend the University to a friend as a good place to work? Why or why not?

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6. Additional Comments:

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|Employee Signature: | |Date: | |

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