Exit Interview Form

Employee Name

  Employee code

 

Division   Designation  Date of Joining   Date of

leaving 

 1. Reasons for leaving (Please specify reasons in the space below the applicable factors)a) Work-relatedi. Work Environment: Excellent / Very Good / Good / Satisfactory / Poor

ii. Job Satisfaction: Excellent / Very Good / Good / Satisfactory / Poor

iii. Support from your Immediate Manager: Excellent / Very Good / Good / Satisfactory / Poor

iv. Rapport with your colleagues: Excellent / Very Good / Good / Satisfactory / Poor

v. Management Style: Courteous / Helpful / Problem Solving

vi. Training Provided: Excellent / Very Good / Good / Satisfactory / Poor

vii. Infrastructure Provided: Excellent / Very Good / Good / Satisfactory / Poor

b) Better Prospectsi. What will be your new designation and role?

ii. Are you taking up additional responsibilities? 

iii. Have you got a better compensation, if so how much?

iv. Which platform are you going to work on?

v. Have you received any overseas work opportunities?  If so, which is the place of work?

vi. Which is your field of interest?  Are you planning for further studies, if so, in which field?

vii. Are you planning to relocate, if so to which place?c) Personal Reasonsi. Financial Constraint

ii. Relocation to Hometown

iii. Further Studies

iv. Better Work Atmosphere

v. Marriage

vi. Family Problem

2. What circumstances would have prevented your departure? (Please specify reasons in the space below the applicable factors)i. Better Work Atmosphere

ii. Better Guidance and Support from your Supervisor

iii. Better Employee Interaction

iv. Additional Support from the Management

v. Better Compensation and Benefit

vi. Additional Roles and Responsibilities

vii. Additional Employee Benefits

viii. Advanced Training in your Field

3. What did you like most about your job?

4. What did you like least about your job?

5. What did you think of your supervisor on the following points?

 Almost Always

UsuallySometim

esNever

Was consistently fair [ ] [ ] [ ] [ ]Provided recognition [ ] [ ] [ ] [ ]Resolved complaints [ ] [ ] [ ] [ ]Was sensitive to employee needs

[ ] [ ] [ ] [ ]

Provided feedback on performance

[ ] [ ] [ ] [ ]

Was receptive to open communications

[ ] [ ] [ ] [ ]

6. How would you rate the following?

  Excellent Good Fair PoorCooperation within your division/program

[ ] [ ] [ ] [ ]

Cooperation with other divisions

[ ] [ ] [ ] [ ]

Personal job training [ ] [ ] [ ] [ ]Equipment provided (materials, resources, facilities)

[ ] [ ] [ ] [ ]

Company’s performance review system

[ ] [ ] [ ] [ ]

Company’s employee orientation program

[ ] [ ] [ ] [ ]

Rate of Pay for your Job [ ] [ ] [ ] [ ]Career Development/Advancement Opportunities

[ ] [ ] [ ] [ ]

Physical Working Conditions

[ ] [ ] [ ] [ ]

7. Was the work you were doing what you expected it to be?[ ] Yes    [ ] NoComments: 

8. Was your workload usually:[ ] Too heavy    [ ] About right    [ ] Too lightComments:

9. How did you feel about the employee benefits provided by the company?[ ] Excellent    [ ] Good    [ ] Fair    [ ] Poor    [ ] No OpinionComments:

10. Would you recommend the company to a friend?[ ] Most definitely    [ ] With Reservations    [ ] NoComments:11. What suggestions do you have to make this a better a place to work?

12. Are you open to the idea of re-joining the organization at a future date?

Summary of Interview: