City of Mathis Exit Interview

Full name

Job Title

Department

Reason for Leaving

Start Date

dd/mm/yyyy

End Date

dd/mm/yyyy

1. Please Rate the following

Rows	1 Unsatisfactory	2 Fair	3 Satisfactory	4 Very Good	5 Outstanding
Job Responsibilities
Opportunity for achieving goals
Work Environment
Supervisor
Pay
Benefits

How long ago did you begin searching for another position ?

What incident or circumstance made you decide to leave the City?

What were the reasons you decided your career goals could not be met her or could be better met somewhere else?

Did you speak with your supervisor or anyone in management or administration concerning your goals or reason you were wanting to leave?

If yes, who did you speak to and what was the outcome of the conversation?

If no, what kept you from speaking to someone?

Did you get along well with your supervisor? If no, please explain.

How well did your supervisor handle complaints or grievances you may have had?

What could have been done to make your job more rewarding?

What did you like best about your job?

What did you like least about your job?

What makes the City of Mathis a good place to work?

What makes the City of Mathis a poor place to work?

How does your new position compare to the one you are leaving?

What recommendations would you have for making your department or the City a better place to work?

Would you have stayed if a satisfactory arrangement could have been worked out? Please explain.

It has been explained to me that completion of this Exit Interview is volunantary and I was given the option not to complete this form if I so desired.

I understand that this form will be placed in my personal file

Any other comments or suggestions you would like to share?

Thank you for your time! Exit interviews are voluntary we appreciate that you took the time to complete it. We wish you the best in your future endeavors.

EXIT INTERVIEW