EXIT INTERVIEW QUESTIONNAIRE
Employee’s Name:
Department/Unit:
Position Title:
Date of Joining:
Date of Relieving :
Reason for Departure: ❑ Resignation ❑ Retirement ❑ Other Reason (specify)
Could you please rate the following aspects of your employment experience with Memorial University?
Salary level & ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
compensation practices
Your Comments:
generally
Insurance benefits ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
Your Comments:
Superannuation benefits ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
Your Comments:
Opportunities for growth ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
& advancement
Your Comments:
Direction received from ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
your Manager/ HOD
Your Comments:
Support received from ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
your Manager/ HOD
Your Comments:
Quality of training and ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
development programs
Your Comments:
Relationships with team/ ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
co-workers
Comments:
Physical working ❑ Excellent ❑ Very Good ❑ Good ❑ Poor ❑ Very Poor
conditions
Your Comments:
Job satisfaction ❑ Very High ❑ High ❑ Average ❑ Low ❑ Very Low
Your Comments:
Questionnaire - Exit Interview Page 1
EXIT INTERVIEW QUESTIONNAIRE
Overall satisfaction with ❑ Very High ❑ High ❑ Average ❑ Low ❑ Very Low
Company as an
Your Comments:
employer
Overall satisfaction with ❑ Very High ❑ High ❑ Average ❑ Low ❑ Very Low
the Department I am
Your Comments:
leaving
Could you please indicate what you enjoyed the most about your employment with the Company?
:
Could you please indicate what you enjoyed the least about your employment with the Company?
May we provide a copy of this Exit Interview Questionnaire to your HOD?
❑ YES ❑ NO If NO, Signature of Employee:
Do you have any further comments or suggestions of a general nature?
Interview Date: Interviewed By:
Interviewer’s Signature:
Questionnaire - Exit Interview Page 2
