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CPO FORM NO.

1-2014

EXIT INTERVIEW FORM


Name: Position :
Date Length of Service:
Hired:
Date of Last Performance Rating:
Exit:
Dept./Office:

Instruction: The exit interview should be completed 30 days before the effectivity date of
separation from the service. An exit interview should be performed by the Department Human
Resource Management Officer with every employee who resigns from their position.

It should be explained to the employee that exit interview notes are taken to enable the City
Government to identify areas that need to be strengthened or improved in the organization.
Monitor issues in the workplace and gather data that can assist in analyzing employee retention
and turnover.

Questions :
1.What is your primary reason (s) for leaving the City Government of Manila?
Better career opportunity (abroad/local) Health
Further Studies Family and/or personal reasons
Relocation/Closer to Home Other (please specify)
Conflict with managers/other employee _______________________
2. What do you like most about your job in the City Government of Manila?
__________________________________________________________________________________________________
________________________________________________________________________
3. What do you like least about your job in the City Government?
__________________________________________________________________________________________________
________________________________________________________________________
4.Did you receive adequate support and feedback about your job performance?
__________________________________________________________________________________________________
________________________________________________________________________
5.what do you think can be improved about the City Government/Department/Management?
__________________________________________________________________________________________________
________________________________________________________________________
Additional comments/suggestions:
__________________________________________________________________________________________________
________________________________________________________________________

_________________________________ ___________________
Employees Signature Over Printed Name Date

___________________________________ ____________________
Interviewers Signature Over Printed Name Date

Thank you for your cooperation! Your response will be treated confidential.