Exit Interview From

(to be competed by Personnel Departement)

Employee’s name ______________________________________________________________________

Company Identification number ___________________________________________________________

Departement __________________________________________________________________________

Dates of employment : from

______________________________________________________________

Supervisor ____________________________________________________________________________

Reason for leaving company ______________________________________________________________

Return of :

□ Keys □ Company Document

□ ID card □ Tools

□ Credit card □ Other company property

Employee informed of position on :

□ trade secrets □ employment with competitor

□ patents □ removing company documents

□ other information □ other __________________________

Please alaborate on these questions : (answer stricty contidential)

1. Do you believe management adequately recognizes employee contributions ?

_________________________________________________________________________________
2. Do you feel that you have had the backing of management on the job ?
_________________________________________________________________________________
3. Did you feel secure in your job ?
_________________________________________________________________________________
4. Did you find your work rewarding ?
_________________________________________________________________________________
5. Do you feel you have been fairly treated by the company ?
_________________________________________________________________________________
 Keluar Dari Wawancara
(akan dikompetisikan oleh Departemen Personalia)
Nama karyawan _______________________________________________________________________
Nomor identifikasi perusahaan ___________________________________________________________
Departemen __________________________________________________________________________
Tanggal kerja: dari _____________________________________________________________________
Pengawas ____________________________________________________________________________
Alasan meninggalkan perusahaan _________________________________________________________
Pengembalian dari:
□ Kunci □ Dokumen Perusahaan
□ KTP □ Alat
□ Kartu Kredit □ Property Perusahaan
Karyawan menginformasikan posisi pada:
□ Bertukar Rahasia □ Pekerjaan dengan pesaing
□ Paten □ Menghapus dokumen perusahaan
□ Informasi Lainnya □ Yang lain _____________________
Tolong jelaskan pertanyaan-pertanyaan ini: (jawab stricty contidential)
1. Apakah Anda percaya manajemen mengakui kontribusi karyawan secara memadai?
______________________________________________________________________________

2. Apakah Anda merasa mendapat dukungan manajemen di tempat kerja?

______________________________________________________________________________

3. Apakah Anda merasa aman dalam pekerjaan Anda?

______________________________________________________________________________

4. Apakah pekerjaan Anda dihargai?

______________________________________________________________________________

5. Apakah Anda merasa telah diperlakukan secara adil oleh perusahaan?

______________________________________________________________________________

___________________________