Exit Interview Form
Partex Star Group (CX 1)
NAME: SEPARATION DATE:
JOB TITLE: TOTAL LENGTH OF SERVICE:
BUSINESS UNIT: JOINING DATE:
1.Please describe the primary reason(s) you are leaving your current position
Better job Going Abroad Personal reason Starting business Others
Please elaborate: (Not mandatory)
2. Please rate the following aspects of the job you are vacating. Use the 1 – 5 scale below.
1 2 3 4 5
(Poor) (Below (Average) (Good) (Excellent)
Average)
Fairness of workload vs. Salary
Working conditions (Tools and equipment,
Training & guidelines)
Co-workers
Supervision received
Level of input in decisions that affected you
Comment
3. Please rate your supervisor on the following factors. Use the 1 – 5 scale below.
1 (Never) 2 (Seldom) 3 (Often) 4(Usually) 5 (Always)
Provided appropriate & challenging
assignments and provided feedback
Recognized accomplishments
Clearly communicated expectations
Provided leadership, trained, & developed you
Encouraged teamwork & cooperation
Resolved concerns promptly
Listened to suggestions & feedback
Kept employees informed
Comment
Thank you for your candid comments. All responses will be kept confidential.
4. Please rate the following aspects of Partex Star Group overall. Use the 1 – 5 scale below.
1 2 3 4 5
(Poor) (Below (Average) (Good) (Excellent)
Average
Career development opportunities
Recognition for your contribution
Support of work-life balance
Cooperation within departments
Communication between
management and employees
Performance, training & dev.
planning and evaluation
Commitment to customer service
Concern with quality and excellence
Administrative polices/procedures
Comment
5. Did dissatisfaction with any of the following factors influence your decision to leave?
(Working conditions, salary, supervisor, location, cost of living, way to commute, etc.)
6. Would you recommend this organization to others as a place to work? Why or why not?
7. What did you find most satisfying about the job?
8. Do you have any other comments or suggestions?
Thank you for your candid comments. All responses will be kept confidential.