Exit Survey

Page 1 of 3     1. First Name*         2. Surname*         3. Department*         4. How long have you been considering leaving this company? * Select at least 1 response and no more than 1 response.   1 month   2-6 months   7-12 months   more than a year       5. Which of the following influenced your decision to leave this company? * Select at least 1 response and no more than 1 response.   Benefits   Career change   Conflict with management   Health   Moving/Relocating   Opportunity for a better job   Pay   Personal reasons   Retiring   Returning to school   Safety   Other, please specify