DSS - Exit Interview Form - Student Success

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First Name

Last Name

Department/Division Unit(i.e. Admission, Counseling, etc)

Immediate Supervisor

Why are you leaving the position?If it was for salary or cost of living, please include that in your answer.

What is an accomplishment you are most proud of during your time in the unit?

What was the most challenging experience?

What resources helped you (or do you wish you had)?(training, materials, etc.)

Is there anything that you want to tell us that you believe would benefit the growth and development of the unit or the Division?

What do you wish you would have known when you started?

Please give a candid assessment of the best and areas of improvement of the unit. What is best (don't change) about the unit? | What areas need improvement (do change)?

In three area:
1. Management
2. Functional Area Operations
3. Office Operations in general

Management

Functional Area OperationsYour work group within the Unit.

Office Operations in general.

Would you like to add anything that was not covered in the other questions?

Please indicate below, if you would like to meet in person with a representative from the office of the Vice President for Student Success.

Yes

Preferred means of contact for meeting set up.

DSS - Exit Interview Form

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