CONFIDENTIAL
EMPLOYEE EXIT INTERVIEW FORM
Name: __________________________________________ Company & ID#: _____________________
Job Title: ____________________________________ Department: ____________________________
Age: _______________ Immediate Superior: __________________ Date Hired: _________________
Gender: ____________ Date Interviewed: ___________________ Separation Date: ______________
REASONS FOR LEAVING
Change in career direction Dissatisfaction with salary
Work Abroad Dissatisfaction with type of work
Pregnancy Dissatisfaction with supervisor / head
Health Issues Dissatisfaction with working conditions
Travel difficulties
Further Studies
Others (specify) _____________________________________________________________________
Plans after leaving
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COMMENTS/SUGGESTIONS FOR IMPROVEMENT
Like Dislike Comments
1. Type of work _______ _______ __________________________
2. Job Security _______ _______ __________________________
3. Career Advancement work _______ _______ __________________________
4. Co-workers _______ _______ __________________________
5. Salary _______ _______ __________________________
6. Benefits _______ _______ __________________________
7. Supervision _______ _______ __________________________
8. Working Hours _______ _______ __________________________
9. Working Conditions _______ _______ __________________________
10. The Management _______ _______ __________________________
(1) What did you like most about your job?
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(2) What did you like least about your job?
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(3) How do you feel about your compensation and benefits?
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(4) How do you feel about the progress you’ve made in the company?
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(5) How do you feel about your supervisor’s managing style?
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(6) What are your suggestions or improvements to your Supervisor?
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(7) What are your suggestions or improvements to Management?
______________________________________________________________________________
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(8) If accepted in another company, what things will you be looking for that you are not getting here?
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(9) Would you recommend the company to your friends/relatives? If no, why?
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Employee Name & Signature / Date
