EMPLOYEE EXIT INTERVIEW RECORD

 Name of Interviewee: …………………………………………………………………………………

 Department: ……………………………………………………………………………………………….
 Date Employed: …………………………………………………………………………………………..
 Entry Salary: …………………………………………………………………………………………………
 Present Salary: ……………………………………………………………………………………………..
 Indebtedness to the Company: ……………………………………………………………………..
 Any indemnity bond to the company: …………………………………………………………..
 Reasons for disengagement:………………………………………………………………………….

Highlights –

Downsides –
Interviewer’s remark:

Q: Is there anything we can do to make you stay?

A:

Q: What in your opinion can we do better as an organisation?

A:

……………………………………… ………………………………………………
Interviewee Signature / Date

Oluseun Ademokun
……………………………………… ………………………………………………
Interviewer Signature / Date