Employee Exit Interview

Thank you for your candid comments. This form will be given to your administrator and the president to assist HLGU in determining weaknesses and strengths in respective areas.

Your Name * First Last
Job Title *
Department *
Supervisor Name * First Last
Start Date with Organization * / MM / DD YYYY

Please select date you started working in any job at HLGU. (Select 1st of month you started if you do not remember the exact date.)
Start Date of Job Position * / MM / DD YYYY
Termination Date * / MM / DD YYYY
Total Length of Service *
Other Position(s) Held with Organization
Please describe the primary reason(s) you are leaving your current position. *
Did dissatisfaction with any of the following factors influence your decision to leave?

Please Select Yes or No. If Yes is selected, please provide a brief comment.

*
	Yes	No
Type of work
Working conditions
Salary
Supervisor
Location
Cost of living in area
Commute

Type of work comment: *
Working conditions comment: *
Salary comment: *
Supervisor comment: *
Location comment: *
Cost of living in area comment: *
Commute comment: *
Other comments about the reason you are leaving:
Please rate the following aspects of the job you are vacating.

Provide comment below for a rating of 1 or 2.

*
	1 - Very Poor	2 - Poor	3 - Average	4 - Good	5 - Excellent
Type of work performed
Fairness of workload
Salary
Working conditions
Tools and equipment provided
Training received
Co-workers
Supervision received
Level of input in decisions that affected you

Type of work performed comment: *
Fairness of workload comment: *
Salary comment: *
Working conditions comment: *
Tools and equipment provided comment: *
Training received comment: *
Co-workers comment: *
Supervision received comment: *
Level of input in decisions that affected you comment: *
Other comments about the job you are vacating:
Please rate the following aspects of the organization overall.

Provide comment below for a rating of 1 or 2.

*
	1 - Very Poor	2 - Poor	3 - Average	4 - Good	5 - Excellent
Recruitment process
New employee orientation
Training opportunities
Career development opportunities
Employee morale
Fair treatment of employees
Recognition for a job well done
Support of work-life balance
Cooperation within the university
Communication between management and employees
Performance and development planning and evaluation
Interest and investment in employees
Commitment to customer service
Concern with quality and excellence
Administrative policies/procedures

Recruitment process comment: *
New employee orientation comment: *
Training opportunities comment: *
Career development opportunities comment: *
Employee morale comment: *
Fair treatment of employees comment: *
Recognition for a job well done comment: *
Support of work-life balance comment: *
Cooperation within the university comment: *
Communication between management and employees comment: *
Performance and development planning and evaluation comment: *
Interest and investment in employees comment: *
Commitment to customer service comment: *
Concern with quality and excellence comment: *
Administrative policies/procedures comment: *
Other comments about the organization overall:
Please rate your supervisor on the following factors.

Provide comment below for a rating of 1 or 2.

*
	1 - Never	2 - Seldom	3 - Often	4 - Usually	5 - Always
Gave usable performance feedback
Recognized accomplishments
Clearly communicated expectations
Treated you fairly and respectfully
Coached, trained, and developed you
Provided leadership
Encouraged teamwork and cooperation
Resolved concerns promptly
Listened to suggestions and feedback
Kept employees informed
Supported work-life balance
Provided appropriate and challenging assignments

Gave usable performance feedback comment: *
Recognized accomplishments comment: *
Clearly communicated expectations comment: *
Treated your fairly and respectfully comment: *
Coached, trained, and developed you comment: *
Provided leadership comment: *
Encouraged teamwork and cooperation comment: *
Resolved concerns promptly comment: *
Listened to suggestions and feedback comment: *
Kept employees informed comment: *
Supported work-life balance comment: *
Provided appropriate and challenging assignments comment: *
Other comments about your supervisor:
If you accepted another job and are willing, please complete the following:
Name of new employer:
Location:
Job title:
Duties:
Salary:
What your new position offers that we do not:
Signature *

Clear

Employee Exit Interview

Employee Exit Interview

Did dissatisfaction with any of the following factors influence your decision to leave?

Please rate the following aspects of the job you are vacating.

Please rate the following aspects of the organization overall.

Please rate your supervisor on the following factors.

If you accepted another job and are willing, please complete the following: