Date: _______________________________
Employee's Name: ____________________________________________________________________________________________________________
Department: _________________________________________________________________________________________________________________
Job Title: ____________________________________________________________________________________________________________________
Supervisor: __________________________________________________________________________________________________________________
Dates of Employment:__________________________________________________________________________________________________________
Reason for Leaving Company: ___________________________________________________________________________________________________
Employee Informed of Restrictions On:
_____________ |
Solicitations of
customers (if applicable)
|
_____________ |
Restrictions on solicitations
of employees |
_____________ |
Removing company documents |
_____________ |
Patents |
_____________ |
Confidentiality obligations |
_____________ |
Customer lists |
_____________ |
Other______________________________________________ |
|
Return of:
| _______________ Keys |
_______________ Credit Card |
_______________ ID Card |
| _______________ Building Pass |
_______________ Company Documents |
|
| _______________ Company Equipment |
_______________ Other Company Property |
|
| |
|
|
What is your primary reason for leaving?
___________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
Do you feel you were treated fairly by the company?
___________________________________________________________________________________
___________________________________________________________________________________________________________________________
Would you consider coming back to the company?____________________________________________________________________________________
___________________________________________________________________________________________________________________________
Were you paid an adequate salary for the work you did?________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
Do you believe management adequately recognized employee contributions?_______________________________________________________________
___________________________________________________________________________________________________________________________
Did you understand company policies and the reasons for them?________________________________________________________________________
___________________________________________________________________________________________________________________________
Have you observed incidences of illegal acts within the company?________________________________________________________________________
___________________________________________________________________________________________________________________________
Do you feel your training was adequate? ___________________________________________________________________________________________
___________________________________________________________________________________________________________________________
Were you content with your working conditions?
______________________________________________________________________________________
___________________________________________________________________________________________________________________________
Are security arrangements appropriate in the company? Could they be improved?____________________________________________________________
___________________________________________________________________________________________________________________________
Do you have any suggestions for improving employee morale?
__________________________________________________________________________
___________________________________________________________________________________________________________________________
What was the best part of your job here? ___________________________________________________________________________________________
___________________________________________________________________________________________________________________________
| ___________________________________ |
| Signature of Person Conducting the Interview |
