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.

"*" indicates required fields

Step 1 of 6

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Your Name*

First Last

Job Title*

Department*

Supervisor Name*

First Last

Start Date with Organization*

MM slash DD slash YYYY

Start Date of Job Position*

MM slash DD slash YYYY

Termination Date*

MM slash DD slash 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?

Type of work*

Yes

Working conditions*

Yes

Salary*

Yes

Supervisor*

Yes

Location*

Yes

Cost of living in area*

Yes

Commute*

Yes

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.

Type of work performed*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Fairness of workload*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Salary*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Working conditions*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Tools and equipment provided*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Training received*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Co-workers*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Supervision received*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Level of input in decisions that affected you*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

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:*

Please rate the following aspects of the organization overall.

Provide comment below for a rating of 1 or 2.

Recruitment process*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

New employee orientation*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Training opportunities*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Career development opportunities*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Employee morale*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Fair treatment of employees*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Recognition for a job well done*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Support of work-life balance*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Cooperation within the university*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Communication between management and employees*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Performance and development planning and evaluation*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Interest and investment in employees*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Commitment to customer service*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Concern with quality and excellence*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

Administrative policies/procedures*

1 - Very Poor

2 - Poor

3 - Average

4 - Good

5 - Excellent

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.

Gave usable performance feedback*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Recognized accomplishments*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Clearly communicated expectations*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Treated you fairly and respectfully*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Coached, trained, and developed you*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Provided leadership*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Encouraged teamwork and cooperation*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Resolved concerns promptly*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Listened to suggestions and feedback*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Kept employees informed*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Supported work-life balance*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Provided appropriate and challenging assignments*

1 - Never

2 - Seldom

3 - Often

4 - Usually

5 - Always

Gave usable performance feedback comment:*

Recognized accomplishments comment:*

Clearly communicated expectations comment:*

Treated you 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:

Printed Name / Consenting Individual*

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