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Please Submit This Form
Confidential Employee Exit Survey
*
Reason(s) for leaving
Took another position
Personal family/home needs
Physical disability
Relocation to another city
Travel difficulties
To attend school
Dissatisfaction with salary
Dissatisfaction with type of work
Dissatisfaction with supervisor
Dissatisfaction with co-workers
Dissatisfaction with working conditions
Dissatisfaction with benefits
Other (please specify below)
If you answered "other" above, please specify.
What are your plans after leaving?
Comments/suggestions for improvement: What did you like most about your job?
Comments/suggestions for improvement: What did you like least about your job?
*
How would you rate the pay for your job?
Excellent
Good
Fair
Poor
*
How would you rate the provided holidays?
Excellent
Good
Fair
Poor
*
How would you rate vacations and personal days?
Excellent
Good
Fair
Poor
*
How would you rate the retirement plan?
Excellent
Good
Fair
Poor
*
How would you rate the health insurance?
Excellent
Good
Fair
Poor
*
How would you rate the flexible spending plan?
Excellent
Good
Fair
Poor
Not Applicable
*
How would you rate the provided sick leave?
Excellent
Good
Fair
Poor
*
How satisfied were you with the opportunity to use your abilities?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
*
How satisfied were you with the recognition you received for the work you did?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
*
How satisfied were you with the training you received?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
Not Applicable
*
How satisfied were you with your supervisor's management methods?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
*
How satisfied were you with the opportunities you had to speak with your supervisor?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
*
How satisfied were you with information you received on policies and procedures?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
*
How satisfied were you with discipline policies and practices?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
*
How satisfied were you with job transfer policies and practices?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
Not Applicable
*
How satisfied were you with overtime policies and practices?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
*
How satisfied were you with performance review policies and practices?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
*
How satisfied were you with your physical working conditions?
Very satisfied
Slightly satisfied
Neutral
Slightly dissatisfied
Very dissatisfied
Name (optional)
*
Date
*
Position
*
Worksite
Years at BOCES 2
Additional Comments
To validate your submission, please answer the following math problem: