EXIT INTERVIEW FORM
Employee Name: Employee Number:
Date of Joining: Last Working Day:
Designation: Project / Group:
The purpose of this interview/survey is to obtain comments and feedback regarding our policies, practices and working
conditions from employees who leave the Company. We plan to use this information to identify areas for improvement.
In order to help us categorize the information, we have asked for several pieces of data from you. You may leave out any
questions you do not wish to answer. We sincerely appreciate your candid comments and answers. Your individual
responses/comments will be kept confidential. Your input will be summarized with other responses and anonymous
feedback provided to the organization.
Section I: Reasons for Leaving
(In case of multiple options rate the options staring from 1 [being high] based on the impact of the reason)
a) Career/promotional opportunity? (Explain) e) Unhappy with environment:
1. Desired advancement opportunity did not seem realistic. 1. Location 4. Personal work area
2. Not chosen for advancement 2. Commute 5. Tools
3. Did not pursue advancement at CoreEL 3. Work hours 6. Other:
4. Other:
b) Different work or career change (Explain) f) Total compensation (Explain)
1. Salary 2. Benefits 3. Other
g) Personal reasons
1. Work Life balance 2. Relocation 3. Others
c) Unhappy with work (Explain) h) Unhappy with Performance Feedback (Explain)
1. Not challenging 1. I received negative performance feedback from my manager.
2. No training offered 2. I was not given appropriate recognition.
3. Work team was not acceptable 3. My manager did not address performance issues effectively.
4. Unhappy with Management Explain:
Section II: Work Life at CoreEL
Parameters (Definition of Scale: 1 = No, 2 = Sometimes, 3 = Yes) Scale
My immediate manager listens to employees suggestions and takes appropriate action
My work group pulls together as a team
Teamwork is good
I was recognized and appreciated for the work I was doing
The management encourages and supports adequate training and development opportunities for me to do
my job successfully
I would recommend CoreEL as a place to work
Version: 3.00 CoreEL Technologies (I) Pvt. Ltd. Page 1 of 2
Date: 16-Mar-2009 Company Restricted.
7) What three improvements has CoreEL made recently?
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8) What three changes would you make to CoreEL or your division?
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9) What would you tell someone who was thinking about working for CoreEL?
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Further comments:
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Section III: On your New Assignment (if applicable)
1) What is your new job title? _____________________________________________
2) What will be your compensation?
Base salary ______________________
Other incentives ______________________________________________________
3) What benefits will you receive that you did not at CoreEL?
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4) Could CoreEL have handled anything differently that would have affected your decision to leave?
Please explain:
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Version: 3.00 CoreEL Technologies (I) Pvt. Ltd. Page 2 of 2
Date: 16-Mar-2009 Company Restricted.
