Archive
By Staff Report
Apr. 24, 2000
A form to use when an employee is leaving the organization.
Employee Separation Evaluation
Employee Name: _______________
Date Completed: _______________
Employee No: _______________
Location: _______________
Supervisor: _______________
Separation Date: _______________
Separation Reason:
_____ Resignation
_____ Reduction in Force
_____ Job Elimination
_____ Performance
_____ Unable to Meet Performance Requirements
_____ Poor Quality/Quantity of work
_____ Attendance
_____ Misconduct
_____ Falsifying Records
_____ Insubordination
_____ Other: _______________
Please check the boxes to evaluate employee’s performance (mark any not applicable as N/A).
Performance Dimension | Below Average | Average | Above Average | Exemplary |
Quality of Work | ||||
Quantity of Work | ||||
Customer Relationships | ||||
Communication | ||||
Problem Solving | ||||
Initiative | ||||
Follow-Up | ||||
Team Work |
If this employee were to apply for employment with the Company again, would you rehire?
_____ Recommend rehire
_____ Do not recommend rehire.
Supervisor: _______________
Regional Manager/Director: _______________
Send all completed forms to Payroll for file.
SOURCE: Mike Smith, P.O. Box 1692 Wal, NJ 07719, ms@mikesmith-hr.com
The information contained in this article is intended to provide useful information on the topic covered, but should not be construed as legal advice or a legal opinion.
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