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Georgia Exit Interview

GEORGIA EXIT INTERVIEW QUESTIONNAIRE

Instructions: We ask each employee who leaves the agency to provide feedback about his or her employment. This information will enable the agency to identify where improvements should be made in various Agency programs and/or work practices. Your participation is strictly voluntary. Please fax your questionnaire to 706-546-2157 or mail to USDA-NRCS, Human Resources, 355 E. Hancock Avenue, Athens, GA 30601.

ALL RESPONSES ARE KEPT CONFIDENTIAL

Part I: Reason for Leaving

From the list below, please check any of the reasons that apply to your decision to leave the Agency. Feel free to explain further in the Other Comments section.

Reason(s) for Leaving: Check:

Retirement………………………………………….. ______

Desire to change type of work……………………… ______

Desire to earn more money………………………… ______

Desire to continue formal education……………….. ______

Desire to work close to home………………………. ______

Management………………………………………… ______

Job stress……………………………………………. ______

Personal health problems…………………………… ______

Difficulties in getting adequate day care………….. ______

Promotion opportunities…………………………… ______

My job was moved geographically………………… ______

Management wanted to fire or demote me………… ______

Relationship with supervisor………………………. ______

Discrimination based on sex, race, age, etc…….….. ______

Other (Specify in Comments Section)……………… ______

Comments/Factors/Explanations:

_____________________________________________________________________________________

Part II-General Attitude

Indicate which best describes your feelings about the following factors.

Please circle ONE response for each.

Agency’s policies or procedures………………..…….………………. ...1 2 3 4

Cooperation and participation between management and employees…...1 2 3 4

Ability to communicate, discuss and resolve concerns and complaints

with supervisors or managers……………………………………… …...1 2 3 4

4. Working conditions (space, heat, furniture, equipment, support, etc.)…..1 2 3 4

Opportunity to participate and utilize skills on task force, collateral… ....1 2 3 4

Duty or detail assignments …………………………………………….....1 2 3 4

Training and development………………………………………………..1 2 3 4

Opportunities for advancement……………………………………….…..1 2 3 4

Promotion practices……………………………………………………….1 2 3 4

10. Organizational changes or reorganization ……………………………...1 2 3 4

11. How sexual harassment issues are handled……………………………….1 2 3 4

12. How the discrimination process based on race, color, gender, age,

national origin, disability, political affiliation, religion, marital, or

family status is handled …………………...……………………………...1 2 3 4

A. Would you return to the Agency?............................................................ ...................YES NO

B. Would you recommend the Agency to a friend as a good place to work?................ YES NO

C. Were you satisfied with your work experience at your Agency?.............................. YES NO

D. Could anything have been done to prevent you from leaving?.............................. .....YES NO

(If YES, please explain below.)

Part IV: Comments/Factors/Explanations:

_____________________________________________________________________________________

Part III: Demographics

Your response to these questions is important. The information will be used for analysis and descriptive purpose only. Your response to these questions will not be separated out individually.

A. LAST GS LEVEL ……………………………………………………………………….._________

B. LENGTH OF SERVICE. …………………………………………………………………_________

C. GENDER Female Male

D. ETHNIC GROUP v American Indian/Alaska Native Asian American/Pacific Islander

Hispanic Black White (not of Hispanic origin) Other

E. AGE 18-29 30-39 40-49 50-59 60 and over

F. DISABILITY Yes ( ___Targeted or ___ Non-Targeted) No