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Exit Interview

This exit interview form collects information from an employee leaving PT. Future Pipe Industries. It asks about the employee's reasons for leaving, ratings of their experience including their supervisor and division, and suggestions to improve the company. The employee is asked to provide feedback on their tenure, working conditions, benefits, and whether they would recommend PT. Future Pipe Industries to others.

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gunawan W
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© © All Rights Reserved
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Download as DOC, PDF, TXT or read online on Scribd
63 views

Exit Interview

This exit interview form collects information from an employee leaving PT. Future Pipe Industries. It asks about the employee's reasons for leaving, ratings of their experience including their supervisor and division, and suggestions to improve the company. The employee is asked to provide feedback on their tenure, working conditions, benefits, and whether they would recommend PT. Future Pipe Industries to others.

Uploaded by

gunawan W
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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EXIT INTERVIEW FORM

Please bring to your Exit Interview or mail to HR Manager

Name (optional) : Supervisor :


Date of Hire : Division :
Termination Date : Department :
Job Title : Location :

Employee Category: Permanent Contract Temporary MTCasual Student

1. What factors contributed to your decision to leave PT. Future Pipe Industries?

Type of work Career change


Salary Family/Personal reasons
Dissatisfaction with management Health
Commuting problems Return to school
Working conditions Better job opportunity
Lack of advancement Retirement
End of Term Position Relocation
Other_______________________________

Please explain.
______________________________________________________________________________________
______________________________________________________________________________________

2. What do you see as the most attractive about your new job?
______________________________________________________________________________________
______________________________________________________________________________________

3. What does the new job offer that PT. Future Pipe Industries does not?
______________________________________________________________________________________
______________________________________________________________________________________

4. What is your opinion of working conditions at PT. Future Pipe Industries?

Good Very Good Good Fair Fair Poor

Comments:
______________________________________________________________________________________
______________________________________________________________________________________

5. Have working conditions changed during your tenure?


Yes  No  Very little 
In what way?
______________________________________________________________________________________
______________________________________________________________________________________

6. How would you rate your supervisor on each of the following points?
Excellent Very Good Good Fair Poor
Demonstrates fair and equitable treatment     
Recognizes staff accomplishments     
Promotes cooperation     
Resolves complaints and problems     
Encourages feedback and suggestions     
Employee health and safety     
Development of staff     
Keeps staff informed     
Other
______________________________________________________________________________________
______________________________________________________________________________________

7. How would you rate the following in your Division?


Excellent Very Good Good Fair Poor
Cooperation within your division     
Cooperation with other divisions     
On-the-job training     
Advancement opportunity     
Communications within your division     
Morale     
Additional comments:
______________________________________________________________________________________
______________________________________________________________________________________

8. What did you like most about working at PT. Future Pipe Industries?
______________________________________________________________________________________
______________________________________________________________________________________

9. What did you like least about working at PT. Future Pipe Industries?
______________________________________________________________________________________
______________________________________________________________________________________

10. What is your assessment of the following at PT. Future Pipe Industries?
Excellent Good Fair Poor No Opinion
Compensation     
Leave Policies     
Health Insurance     
Retirement Program     
Opportunity for Advancement     
Job Posting Policy/Process     
Training-Education Programs     
Performance Appraisal System     
Health Services Program     
Diversity     
11. Would you recommend a friend to pursue employment with PT. Future Pipe Industries?
Yes, definitely Yes, with reservations No
If No/Reservations, please explain:
______________________________________________________________________________________
______________________________________________________________________________________

12. May we share the information you have provided on this form with others in:
Your department management? ………………… Yes No
PT. Future Pipe Industries management? …………………. Yes No

13. What suggestions would you offer to make PT. Future Pipe Industries a better place to work?
______________________________________________________________________________________
______________________________________________________________________________________

Employee Signature: Date:

Thank you for taking the time to share your thoughts and opinions.

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