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TOOL Exit Interview Questionnaire

By Staff Report

Apr. 10, 2000

January 20, 2000


 


To:


Tracy L. Quick


 


1234 Fish Pond Road


 


Big Lake, MN 55372


 


 


Subject:


Feedback


 


It has been a short time since you left _______________. Regardless of the reason you left, we hope your current situation or prospects are looking good.


We would like your help. We sincerely want to know what people that have worked with us feel and believe about our organization, management, and people.


Please complete the short questionnaire, attached to this letter and return it to us in the enclosed pre-paid envelope. You do not need to include your name. However, if you would be willing to talk about your feedback, please include your name and a phone number where we may contact you.


Thank you,


 


 


Human Resources Department


 




EXIT QUESTIONNAIRE


As a former 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):
_________________________


Termination 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 give your name and telephone number if you would like to talk to us:)
_________________________
_________________________




Section B


Please use the following ratings for Section B.


Not satisfied
1   2   3   4


Acceptable
5   6


Satisfied
7   8   9   10


Training received


1


2


3


4


5


6


7


8


9


10


Company benefits


1


2


3


4


5


6


7


8


9


10


Career opportunities


1


2


3


4


5


6


7


8


9


10


Supervision received


1


2


3


4


5


6


7


8


9


10


Working conditions


1


2


3


4


5


6


7


8


9


10


Pay for work required


1


2


3


4


5


6


7


8


9


10


Type of work performed


1


2


3


4


5


6


7


8


9


10


Work schedule


1


2


3


4


5


6


7


8


9


10


The job met my expectations


1


2


3


4


5


6


7


8


9


10


The company’s commitment to customer service


1


2


3


4


5


6


7


8


9


10


Did you receive feedback from your manager? (circle one)
YES   NO


If you did receive feedback from your manager, how helpful was it? Explain why it was or was not helpful.


 


 


 


 


What did you like best about working for _______________?


 


 


 


 


What did you like least about working for _______________?


 


 


 


 


In terms of compensation and benefits, what would it have taken for you to stay with us?


 


 


 


Please tell us the type of work (job title) that you have now:
_________________________


Pay for this job is: __________


Please provide any additional information you feel will help _______________ exceed customer’s expectations, attract and retain excellent employees.


 


 


 


 


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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