Exit Questionnaire Form

University of Denver
Employee Exit Interview
General Guidelines for Employee:
Thank you for taking the time to fill out this form. Your honest input and comments
are very important to us as an employer so that we can assist in developing a positive
work environment across the many departments of the university.
This form will be kept confidential and using your responses only for statistical data.
Specific information will not be shared with your supervisor and/or department
coworkers.
We really encourage you to schedule an in-person interview by calling Human
Resources at 303-871-3103. If you are unavailable to attend, please complete as
much of the survey as possible and return the Human Resources department:
Mary Reed Building
2199 S. University Blvd.
4th Floor
Thank you for your time here at the University of Denver and we wish you well in
your future employment endeavors!
Exit Interview 2016
Exit Interview Form
Employee Name or DUID# : ____________________________ Date: _____________
Position Held: _______________________________________ Staff or Faculty: (circle one)
Exempt or Non-Exempt (circle one) Department: ________________________________
Supervisor (optional): _________________________ Length of Service: ______________
1. What is your gender identity? (Optional)
Female Male
Please describe: ______________
2. Please check one of the following that apply: (Optional)
American Indian or Alaska Native
Hispanic or Latino
Asian
Native Hawaiian or Other Pacific Islander
African American or Black
White or Caucasian
Multiple (two or more races)
Undeclared
3. Before you made the decision to leave the University, did you speak with someone about other
internal options?
Yes
No
If yes, what options were offered?
______________________________________________________________________________
______________________________________________________________________________
5. DU’s commitment to diversity
6. University’s culture
7. Opportunity for growth
8. Opportunity for advancement
9. Opportunity for transfer
10. Opportunity for promotions
11. Competency of upper management
Exit Interview 2016
Not Acceptable
Poor
Below Average
Average
Good
What is your opinion of the following:
Excellent
4. Please provide the most important reason(s) you decided to leave the University of Denver.
Layoff
Pay
Retirement
Employee Benefits
Stress
Excessive workload
Personal illness/Family illness
Relocation
Dissatisfaction with supervisor
Inadequate training provided
Better position
which best utilizes my skills and abilities
Insufficient opportunity for career growth and learning
Insufficient opportunity for advancement and promotion
Insufficient work assignments
Other:___________________________________________________
Not Acceptable
Poor
Below Average
Average
Good
Excellent
Rate your department on the following:
Not Acceptable
Poor
Below Average
Average
Good
Rate the following benefits:
Excellent
12. Communication with employees
13. Training received
14. Equity
15. Demonstration of qualities & principles
16. Provides recognition on the job
17. Follows policies and practices
18. Base Salary
19. Medical insurance
20. Dental insurance
21. Life insurance
22. Retirement plan
23. Tuition Waiver
24. Vacation/Sick leave
25. Why have you decided to resign from the University of Denver? (If Applicable)
______________________________________________________________________________
______________________________________________________________________________
26. What could have been done to keep you from resigning? (If Applicable)
______________________________________________________________________________
______________________________________________________________________________
27. Looking back, what were some of the original factors that made DU your employer of choice?
______________________________________________________________________________
______________________________________________________________________________
28. If you accepted another job, what is that job offering you that DU has not?
______________________________________________________________________________
______________________________________________________________________________
29. Would you consider returning to DU for future employment?
Yes
No
30. What recommendations would make your department a better place to work?
______________________________________________________________________________
______________________________________________________________________________
31. Any other comments or concerns?
______________________________________________________________________________
______________________________________________________________________________
Exit Interview 2016