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Exit Interview Sample Template


Question 1.  
Mandatory Question Your Details
Name
Department
Position

 
Question 2.  
Mandatory Question Date of Resignation:

Question 3.  
Your Age
Selection 18 - 20
Selection 21 - 22
Selection 23 - 25
Selection 26 - 28
Selection 29 - 32
Selection 33 - 40
Selection 41+
Question 4.  
Gender
Selection
Male
Selection
Female
Question 5.  
Mandatory Question Term of employment with your company
Selection Less than 3 months
Selection 3 - 6 months
Selection 6 - 12 months
Selection 12 - 18 months
Selection 18 - 24 months
Selection 2 - 3 years
Selection 3 - 4 years
Selection 4 - 6 years
Selection 6 - 8 years
Selection 8 years +