1. EXIT INTERVIEW QUESTIONNAIRE
MS-EI-015/03-008
Department _________________________________ Length of Employment______________
Job Title: ____________________________________________________________________
As you leave your employment, we would like to hear your thoughts and suggestions regarding your job with
Mabani Steel. Exit interview information is for internal HR Department use to assist in the analysis of
management and organizational issues and trends. Department Heads will be provided with a summary
of exit interview questionnaire responses as a tool for continuing improvement efforts.
When you have completed this questionnaire, you will have an opportunity to discuss your responses in a
personal interview with a representative of the Human Resource Department.
1. What three things did you like most about your job with Mabani Steel?
2. What three things did you dislike most about your job with Mabani Steel?
3. What is your opinion of the following: 4 3 2 1
Poor Fair Good Excellent
Benefits
 4
 3
 2
 1
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2. EXIT INTERVIEW QUESTIONNAIRE
MS-EI-015/03-008
Training Opportunities
 4
 3
 2
 1
Opportunities for Advancement
 4
 3
 2
 1
Your Salary for the work you were assigned
 4
 3
 2
 1
Salary Increments
 4
 3
 2
 1
Performance Appraisal System
 4
 3
 2
 1
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3. EXIT INTERVIEW QUESTIONNAIRE
MS-EI-015/03-008
Management Support
 4
 3
 2
 1
Communication within your department
 4
 3
 2
 1
Organizational Culture
 4
 3
 2
 1
Comments: (If you rated any of the above “Poor”, please explain why.)
4. Rate your supervisor in the following areas: 4 3 2 1
Poor Fair Good Excellent
Fairness
 4
 3
 2
 1
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4. EXIT INTERVIEW QUESTIONNAIRE
MS-EI-015/03-008
Leadership ability
 4
 3
 2
 1
Technical ability
 4
 3
 2
 1
Communication skills
 4
 3
 2
 1
Comments:
5. Rate your Department Head in the following areas: 4 3 2 1
Poor Fair Good Excellent
Visibility
 4
 3
 2
 1
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5. EXIT INTERVIEW QUESTIONNAIRE
MS-EI-015/03-008
Accessibility
 4
 3
 2
 1
Communication Skills
 4
 3
 2
 1
Leader ship
 4
 3
 2
 1
Willingness to constructively address problems
 4
 3
 2
 1
Comments:
6. What three things, in your opinion, would lead to improvement in your department?
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6. EXIT INTERVIEW QUESTIONNAIRE
MS-EI-015/03-008
7. Why are you leaving?
___ Job Dissatisfaction ___ better job offer
___ Retirement ___ more opportunity for career advancement
___ moving out of area ___ more money
___ returning to home country ___ greater responsibility – higher level job
___ leaving the work force ___ more desirable work schedule
___ Better benefits offered ___ other ___________________________
Signature __________________________________________
(Optional)
For HR Personnel Use:
Interviewer ______________________________________ Date _________________________
Comments:
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