Mamma Maria’s Pizza

EXIT INTERVIEW QUESTIONNAIRE

NAME DATE TODAY

POSITION DATE HIRED

OUTLET DATE SEPARATED

DEPT SERVICE YEARS

Please rate each given factor on the basis of your overall observation during your stay with
the Company. Put a check mark (√) on the column of your rating.

AREA VERY GOOD ACCEPTABLE NEEDS IMPROVEMENT

Management Style __________ ___________ ___________________

Physical Working
Environment __________ ___________ ___________________
Benefits &
Compensation __________ ___________ ___________________
Employee
Relationships __________ ___________ ___________________
Company & Job
Orientation __________ ___________ ___________________
Training &
Development __________ ___________ ___________________
Job Functions &
Related Duties __________ ___________ ___________________
Style & Degree of
Supervision __________ ___________ ___________________
Opportunities for
Growth &
Advancement __________ ___________ ___________________
Company Policy and
Administration __________ ___________ ___________________

We aim for continuous improvement and your opinion would be greatly evaluated and
appreciated. Please give us your honest feedback/comment on the following questions.
Rest assured that all information will be treated with utmost confidentiality and will be
disclose only to authorized persons.

1. What do you like most and least about your job function and its related duties?
_____________________________________________________________________
_____________________________________________________________________
2. What do you think needs to be improved in the current system and methods in your line
of work? What suggestions can you give to us in order to improve them?
______________________________________________________________________
______________________________________________________________________

3. How is your relationship with your Supervisor? Do you think there is an appropriate
degree of supervision given to you and other to achieve you desired work output?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

4. How would you describe the management style of the company?

______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

5. What do you appreciate most about the company itself? What do you like least?
______________________________________________________________________
______________________________________________________________________

6. Why do you want to discontinue your employment with the Company?

______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

7. Is there any other information that you would like us, to know that would contribute to
the company’s improvement? If yes, what are those?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Signature of Date
Employee _______________________ Accomplished _______________________

Thank you very much. We wish you the best of luck in your future endeavor that you will
undertake.

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FOR INTERVIEWER USE

Interviewed by: ____________________________ Date: ___________________

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