Staff Exit Survey
We would appreciate it if you filled in this survey as honestly and as accurately as you can, so that we can analyse our effectiveness as an employer in the future.

The answers to the following survey will be treated in the strictest confidence.
Section 1: Reason for leaving
(Please tick all that apply)
Pregnancy
Ill Health
Contract ended
Promotion/move to another Department
Dismissed
Redundancy
Retired
Move to another area
Found a job with more prospects/opportunities
Found a job which offered more pay
Found a job which offered more benefits
Found a job with better Working conditions
Change in working hours desired
Prefer not to say
Other
Section 2 - Your Current Job
Job Satisfaction:
Did any of the following influence your decision to leave your current job?
(Please tick all that apply):
Unhappy with current pay
Unhappy with current conditions
Insecure in current job
Your job here was too stressful
Dissatisfaction with current job
Insufficient training/support in job
Unhappy with another member of staff/employer
Prefer not to say
Unhappy with current job
Other
Did your job here live up to expectations?
Which aspects of your job did you like best?
Which aspects of your job did you like least?
Are there any other reasons, which influenced your decision to leave?
(Please state below)
Section 3 Resignation Details
What date will you leave the company/department?
Have you had an exit interview with your line manager/immediate superior or Personnel Officer?
Yes
No
How long have you been looking for another Job?
Less than 4 weeks
Between 4 and 12 weeks
Between 3 - 6 months
Over 6 months
Wasn't looking
Did you speak to your Line Manager/Immediate Superior or Personnel department before offering your resignation?
Yes
No
Did you wish to stay working with us?
Yes
No
When was your last staff appraisal with us?
Less than 6 months ago
Between 6 and 12 months ago
Between 1 and 2 years ago
Over 2 years ago
Never had an appraisal
How much notice did you give before leaving your job with us?
Less than 4 weeks
Standard 4 weeks
More than four weeks
None
Do you believe your pay was within industry range?
Yes
No
Do you believe your job with us was paid fairly?
Yes
No
Is there anything we could have done to make you stay longer?
(Please state below)
Section 4 Your new job
Does your new job offer you any additional benefits?
(if so, please state these below)
If our company also offered these benefits would you have stayed longer?
Yes
No
Does your new job offer any of the following benefits?
More pay
Better working conditions/environment
Shorter working hours
Longer holiday entitlement
Less travelling to work
Improved job title/position
Other benefits
(Please specify)
Would you work for us again in the future?
Yes
No
Would you recommend our company to other job seekers?
Yes
No
Section 5 - Personal Information
Forwarding Address:
Your name
Date of leaving
How long have you been with this company?
Less than 1 year
Between 1 and 2 years
Between 5 and 10 years
Over 10 years
What is your age range?
16 - 25 years
25 - 35 years
35 - 45 years
45 - 55 years
Over 55
Which Department do you work in?
Department 1
Department 2
Department 3
Department 4
Department 5
What is your payscale on leaving?
Level 1
Level 2
Level 3
Level 4
Level 5
What is your current Job title?
This section is not seen by exiting employee
How much notice were you given regarding this employee leaving?
Less than 4 weeks
Standard 4 weeks
More than four weeks
None
Were you aware that the employee was actively searching for another job?
Yes
No
Was there a better opportunity available for this employee within the company which might have made them stay (example in another department)?
Yes
No
How valuable was the employee to this company?
Very valuable
Valuable
Average
Poor value
Very poor value
If you answered 'yes' to the question above, did you discuss other opportunities with the exiting employee?
Yes
No
Where you happy for them to go?
Yes
No
Were you asked to supply a reference for them for the new job?
Yes
No
(OPTIONAL Please attach reference to this form)
Did you try to make the employee stay with the company?
Yes
No
Exit Interview conducted by:
Date
Notes:


This survey was created byKeyPoint