Exit Interview Form

Employees who have decided to voluntarily resign from the University are asked to complete the following questionnaire. The purpose of the questionnaire is to obtain information regarding your employment experience at the University. The completion of this exit interview form is completely voluntary.

A. Employee Details
Name Name First Last
Employee Number:
Department:
Manager:
Position/Title:
Start Date Start Date / MM / DD YYYY
Termination Date Termination Date / MM / DD YYYY
1. What motivated you to pursue and accept a role in a different organization? (Select all that apply)

1. What motivated you to pursue and accept a role in a different organization? (Select all that apply) Starting own Business Commuting Distance Relocation Career Advancement Different Type of Work More Responsibility Compensation/Benefits Management Department Structure University Culture Work/Life Balance Working Conditions Other
2. Which of the selected factors above was the most important to you?
C. Please complete this section if your reason for leaving is for a position at another organization:
3. What is the name of your new employer?
4. What is your new position?
5. What most attracted you to the new role/employer?
6. Will this new position have more responsibility?
D. Please respond to the following questions relating to your current position:
7. What factors led you to accept a role with the University?
8. How has your perception of those factors changed during the time that you have been employed by the University?
9. Did the role meet your expectations?
10. What aspects do you enjoy most in your current role?
11. What aspects do you enjoy least in your current role and why?
E. Please rate the following statements based on your experience in:

Please answer the following questions:
Please answer the following questions:	Always	Almost Always	Sometimes	Never
12. I received adequate training to do my job	12. I received adequate training to do my jobAlways	12. I received adequate training to do my jobAlmost Always	12. I received adequate training to do my jobSometimes	12. I received adequate training to do my jobNever
13. I received adequate support to do my job	13. I received adequate support to do my jobAlways	13. I received adequate support to do my jobAlmost Always	13. I received adequate support to do my jobSometimes	13. I received adequate support to do my jobNever
14. Job expectations were communicated to me by my manager/supervisor	14. Job expectations were communicated to me by my manager/supervisorAlways	14. Job expectations were communicated to me by my manager/supervisorAlmost Always	14. Job expectations were communicated to me by my manager/supervisorSometimes	14. Job expectations were communicated to me by my manager/supervisorNever
16. I was provided with challenging work	16. I was provided with challenging workAlways	16. I was provided with challenging workAlmost Always	16. I was provided with challenging workSometimes	16. I was provided with challenging workNever
17. I received sufficient feedback about my performance	17. I received sufficient feedback about my performanceAlways	17. I received sufficient feedback about my performanceAlmost Always	17. I received sufficient feedback about my performanceSometimes	17. I received sufficient feedback about my performanceNever
18. I had help from the University to fulfill my career goals	18. I had help from the University to fulfill my career goalsAlways	18. I had help from the University to fulfill my career goalsAlmost Always	18. I had help from the University to fulfill my career goalsSometimes	18. I had help from the University to fulfill my career goalsNever

Comments
F. Please rate how satisfied you were with respect to the following areas, on a scale of 1 to 5 (with 5 being the most positive and 1 being the least positive).

Please answer the following questions:
Please answer the following questions:	1	2	3	4	5
19. Career/ professional development expectations were met	19. Career/ professional development expectations were met1	19. Career/ professional development expectations were met2	19. Career/ professional development expectations were met3	19. Career/ professional development expectations were met4	19. Career/ professional development expectations were met5
20. Salary and Benefits Package	20. Salary and Benefits Package1	20. Salary and Benefits Package2	20. Salary and Benefits Package3	20. Salary and Benefits Package4	20. Salary and Benefits Package5
21. Opportunities for Development	21. Opportunities for Development1	21. Opportunities for Development2	21. Opportunities for Development3	21. Opportunities for Development4	21. Opportunities for Development5
22. Work Environment	22. Work Environment1	22. Work Environment2	22. Work Environment3	22. Work Environment4	22. Work Environment5
23. Work-life Balance	23. Work-life Balance1	23. Work-life Balance2	23. Work-life Balance3	23. Work-life Balance4	23. Work-life Balance5
24. Physical Working Environment	24. Physical Working Environment1	24. Physical Working Environment2	24. Physical Working Environment3	24. Physical Working Environment4	24. Physical Working Environment5

Comments
G. Please respond to the following questions in relation to your work at the University:
25. How would you rate the quality of the supervision you received?
26. What did you most enjoy about working for the University?
27. What did you least like about working for the University?
28. Overall, how do you feel about your experience of working for the University?
29. Would you consider working for the University again at some point in the future?

29. Would you consider working for the University again at some point in the future? Yes No
If no, why?
30. Would you recommend working for the University to a prospective employee?

30. Would you recommend working for the University to a prospective employee? Yes No
31. Do you have any other comments to add?
H. Additional Comments by the Interviewer/Actions to be Carried Out?
32. What could the University have done to prevent you from leaving?
33. What would make the University a better place to work?
I. Compliance
Do you have any knowledge of an unreported situation involving suspected or actual violations of law, Title IX or the University’s Code of Conduct? If yes, please provide details for the investigatory process.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY

Exit Interview Form

Exit Interview Form

A. Employee Details

C. Please complete this section if your reason for leaving is for a position at another organization:

D. Please respond to the following questions relating to your current position:

E. Please rate the following statements based on your experience in:

F. Please rate how satisfied you were with respect to the following areas, on a scale of 1 to 5 (with 5 being the most positive and 1 being the least positive).

G. Please respond to the following questions in relation to your work at the University:

H. Additional Comments by the Interviewer/Actions to be Carried Out?

I. Compliance