Online Exit Survey Form

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Exit Survey

Employment Experience
Please rate the following on a scale of 1(poor) to 5 (excellent):
The overall work environment:*	1 2 3 4 5
The co-operation/friendliness of the work environment:*	1 2 3 4 5
The physical work environment:*	1 2 3 4 5
The quality of training received:*	1 2 3 4 5
Availability of resources to perform your job:*	1 2 3 4 5
The cultural sensitivity of staff and management:*	1 2 3 4 5
The quality of supervision you received:*	1 2 3 4 5
The extent of which your skills were utililized:*	1 2 3 4 5
The distribution and accountability for work assignments:*	1 2 3 4 5
Compensation & benefits:*	1 2 3 4 5
Please answer the following questions:
Would you recommend this company as a place to work?*	Yes No
Is there a particular practice or working condition that led to your resignation?*		please explain
What recommendation(s) would you make to help us improve?
Additional Comments:
Certification and Filing Instructions
I certify that the information that is contained in this report is true and accurate.
Signature:*		fill in your name
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