Archive
By Staff Report
Apr. 11, 2000
You can use the following short questionnaire in conjunction with an exit interview conducted on-site. The following is just an example.
EXIT INTERVIEW
As a resigning associate of _______________, you can be a valuable source of information regarding various working conditions observed during your period of employment.
Please be assured that your questionnaire will not become a part of your permanent personnel record file, and your comments will in no way affect your re-employment possibilities should you desire to seek employment again with _______________.
We are striving to maintain a positive working environment and hope that your suggestions, comments and observations will aid us in accomplishing this goal.
ASSOCIATE S NAME (OPTIONAL):
_________________________
Resignation Date: | _______________ | Hire Date: | _______________ |
Job Title: | _______________ | Location: | _______________ |
(PLEASE PLACE AN “X” BESIDE YOUR REASON FOR LEAVING.)
REASON FOR LEAVING: (Mark as many as apply)
_____ 1. Secured a different job
_____ 2. Dissatisfied with pay
_____ 3. Moving from area
_____ 4. Family circumstances
_____ 5. Health reasons
_____ 6. Dissatisfied with type of work
_____ 7. Other (please explain)
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(PLEASE RATE THE FOLLOWING FROM 1 TO 10 — WITH 10 BEING THE BEST)
Training received | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments | ||||||||||
Company benefits | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments | ||||||||||
Career opportunities | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments | ||||||||||
Supervision received | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments | ||||||||||
Working conditions | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments | ||||||||||
Pay for work required | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments | ||||||||||
Type of work performed | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments | ||||||||||
The job met my expectations | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments | ||||||||||
The company s commitment to customer service | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Comments |
Please provide any additional information you feel will help _______________ exceed customers’ expectations, attract and retain excellent employees.
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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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