We would like to have your comments regarding your employment with our company. Completion of this exit interview is entirely voluntary. If you choose to complete it, please return it to us and we will keep your remarks confidential.
Date:	___________________	
Name:	____________________________________________________

1.	Why are you leaving the company? 
	_________________________________________________________
	_________________________________________________________ 

2.	What did you enjoy most about working here? 
	_________________________________________________________
	_________________________________________________________ 

3.	What did you enjoy least about working here? 
	_________________________________________________________
	_________________________________________________________ 

4.	What could the company have done or provided to help you become even more productive? 
	_________________________________________________________ 
	_________________________________________________________

5.	How was your relationship with your supervisors? 
	_________________________________________________________
	_________________________________________________________ 

6.	Do you think the compensation you received is competitive with what others doing the same or similar jobs for other companies receive?
	_________________________________________________________
	_________________________________________________________ 

7.	If you are leaving the company for another job, we would appreciate the following information:
	New company:			______________________________ 
New job title and duties:	______________________________ 
Is the new job a step up for you in terms of compensation and/or status?  Yes     No  

8.	Other comments?
	_________________________________________________________ 

Thank you for your assistance.  
We wish you the best in your future endeavors!