Exit Interview Form

We would appreciate you taking about 8-10 minutes to answer the following questions ashonestly as possible. Your responses are treated as confidential. We believe that theinformation is of vital importance and will assist us analyzing our employee retention andturnover.

Name:Department:Position:Date of Joining:1. What prompted you to seek alternative employment?

[ ] Type of Work[ ] Quality of Supervision[ ] Compensation[ ] Work Conditions[ ] Lack of Recognition[ ] Family Circumstances[ ] Company Culture[ ] Career Advancement Opportunity[ ] Business/Product Direction[ ] Other:

2. Before making your decision to leave, did you investigate other options that wouldenable you to stay?

[ ] Yes [ ] NoIf Yes, describe:

3. What did you think of your supervision in regard to the following?

AlmostAlwaysSometimesNeverComments

Demonstrated fairand equal treatment[ ][ ][ ]Provided recognitionon the job[ ][ ][ ]Developedcooperation andteamwork[ ][ ][ ]Encouraged/listenedto suggestions[ ][ ][ ]Resolved complaintsand problems[ ][ ][ ]Followed policiesand practices[ ][ ][ ]

4. How would you rate the following in relation to your job?

ExcellentGoodFairPoorComments

Cooperationwithin yourdepartment[ ][ ][ ][ ]Cooperation withotherdepartments[ ][ ][ ][ ]Communicationsin yourdepartment[ ][ ][ ][ ]Communicationswithin thecompany as awhole[ ][ ][ ][ ]Communicationsbetween you andyour manager[ ][ ][ ][ ]Morale in yourdepartment?[ ][ ][ ][ ]Job Satisfaction[ ][ ][ ][ ]Training youreceived[ ][ ][ ][ ]Growth Potential[ ][ ][ ][ ]

5. Was your workload usually:

[ ] Too great[ ] Varied, but all right[ ] About right[ ] Too light

6. How did you feel about your salary and the employee benefits?

[ ] Excellent[ ] Good[ ] Fair[ ] PoorComments: