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Exit Interview Form: Name of Employee: Employee No: Designation: Function: Date of Leaving The Organization

This document is an exit interview form for an employee leaving an organization. It collects information such as the employee's name, number, designation, leaving date, and reason for resigning. The employee is asked to rate different aspects of their work experience on a scale of 1 to 10. Open questions inquire about the specific triggers for their decision to quit, any uncomfortable factors or experiences, suggestions for improvement, and whether they would return or recommend the company. The form certifies the employee's new role and collects their signature. The purpose is to gather confidential feedback to help the organization improve.

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anujkhera
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201 views

Exit Interview Form: Name of Employee: Employee No: Designation: Function: Date of Leaving The Organization

This document is an exit interview form for an employee leaving an organization. It collects information such as the employee's name, number, designation, leaving date, and reason for resigning. The employee is asked to rate different aspects of their work experience on a scale of 1 to 10. Open questions inquire about the specific triggers for their decision to quit, any uncomfortable factors or experiences, suggestions for improvement, and whether they would return or recommend the company. The form certifies the employee's new role and collects their signature. The purpose is to gather confidential feedback to help the organization improve.

Uploaded by

anujkhera
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Exit Interview Form

Name of Employee:

Employee No:

Designation:

Function:

Date of leaving the organization:

The exit interview feedback will be maintained strictly confidential and will be shared only with the Senior
Management. The information so gathered will help us change or improve the organization as relevant and
necessary. In your feedback, please also include areas / items that may not have been covered in the
questionnaire.

Reason for resignation:

[ ] Better or higher role [ ] Better compensation/ benefits


[ ] Inadequate Opportunities for Career Growth [ ] Lack of Recognition
[ ] Personal Reasons [ ] Relocating
[ ] Relationship with Manager/ Peers [ ] Retirement
[ ] Return to Academic Career [ ] Others
_________________________

Kindly assign ranks to the following aspects of your experience in working with us:

Use ranks from 1 to 10; where 10 indicates The Best and 1 indicates The Worst aspects of your experience in
the work environment

Rank
Office facilities
Freedom at work
Relationship with your peers
Relationship with your superior(s)
Salary & benefits
Organization policies
Systems and processes
Work culture
Career growth
Professional development
Describe in brief any particular reason or event that triggered your decision to quit.

What have been the factors or experiences that made you uncomfortable during your tenure? What are your
suggestions to address them?

Would you consider returning to this company in the future?

Would you recommend this company to a friend as a good place to work?

Is there anything the company could have done to prevent you from leaving?

I certify that I am joining ___________________________ (organization) as ___________________ (designation)

Employee Signature

Thank you very much for taking the time to complete this questionnaire.
We wish you all the best in your future endeavor!

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