1. Please specify your gender. Male Female
2. What department were you working in? Administration Customer Service Finance Human Resources Information Technology Marketing Sales Other
3. For how long did you work in our company? Less than six months Less than a year Less than two years Less than 5 years Less than 10 years
4. What was your motivation for joining our company? (Choose all that apply.) Needed work Remuneration Employee benefits Career advancement Company's reputation Company's mission Other
5. For what reason(s) are you leaving the company? (Choose all that apply.) Remuneration Employee benefits Career advancement Career change Conflict with supervisor Conflict with management Conflict with co-workers Working conditions (physical conditions of work, working hours, workload, etc.) Nature of work Job security and stability Personal reasons Relocation Higher education Other, please specify.
6. What kind of organization is your new place of work? Commercial Governmental Non-governmental Not applicable
7. Please give a brief description of the kind of work and responsibilities you will be handling in your new place of work. (Optional)
8. Do you think you could have a similar opportunity in our company? Yes No Can't say
9. If you had a similar opportunity in our company, would you have stayed? Yes No Can't say
10. Please rate the following aspects of the job you held with us.
11. Please select the option that best describes the following statements about your immediate supervisor.
12. Please select the option that best describes the following statements about the management.
13. Did you ever have any kind of grievance during the course of your employment with our company? Yes No If yes, was the grievance resolved?
14. The grievance handling procedure was: Highly effective Effective Somewhat effective Ineffective Not applicable
15. If you have any suggestions regarding changes/improvements that can be made in the company, please write them in the space below.
16. Would you ever consider working with us again? Yes, why not. I don't think so. Can't say.
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