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Employee Exit Survey
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Human Resources
Employee Exit Survey
Employee Exit Survey
Note: Fields marked with an * are required.
Section 1
School District
*
Madison - 41
School Site
*
District Office
Madison County High School
Madison County Central School
Lee Elementary School
Pinetta Elementary School
Greenville Elementary School
Grade Level / Department
*
Section 2
Employee Information
Employee Type
*
Administative
Instructional
Non-Instructional
Last Name
*
First Name
*
Future Address
Street
*
City
*
State
*
2 Letter State Abbreviation
Zip Code
*
Cell Phone
*
Format: 555-555-5555
Date of Departure
*
Format: mm/dd/yyyy
Reason for Departure
*
Length of Service to MCSD
*
Number of Years
Section 3
Future Plans
Indicate one of the following regarding your future plans
Accept another teaching position
Accept another position in education
Accept a position outside the field of education
No current plans
Nonpublic
Public
Out of State
Grades Completed
Yes
No
Keys Turned In
Yes
No
Returned All Technology
Yes
No
Contacted Human Resources
*
Yes
No
Contacted Finance
*
Yes
No
Contacted Insurance
*
Yes
No
Human Validation
Equity/ Grievance
Employee Exit Survey
Certification
Career & Technical Education (CTE)
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