Form 0 OPM Employee Exit Survey

Generic Customer Satisfaction

Exit Survey_2009

OPM Exit Survey

OMB: 3206-0236

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OMB Approved:

            No. 3206-0236

EXIT SURVEY




































Public Burden Statement:

We estimate this form takes an average of 15 minutes to complete including the time for getting the needed data and reviewing both the instructions and completed form. Send comments regarding our estimate or any other aspect of this form, including suggestions for reducing completion time, to the Office of Personnel Management (OPM), Assessment Services, Steve Burnkrant (3206-0236), Washington, DC 20415-7900. The OMB Number, 3206-0236, is currently valid. OPM may not collect this information, and you are not required to respond, unless this number is displayed.


PART I – Reasons for Leaving


  1. Which of the following statements best describes the type of separation from your organization?

O

I resigned to leave the Federal government

O

I transferred within my agency

O

I transferred to another Federal agency

O

I retired due to disability

O

I retired voluntarily

O

I left involuntarily, due to a RIF

O

I left involuntarily, due to termination

O

I left involuntarily, due to contracting out

O

Other, please specify ____________________________________________


Were you asked or encouraged to leave your job? [If marked a, b, or c in item 1]

O

No, I left for my own reasons

O

Yes, because of poor performance or a personal conflict

O

Yes, because I was encouraged to pursue an opportunity elsewhere


Would you have continued working if your job or working conditions had been better? [If marked e in item 1]

O

No, I was ready to retire

O

Yes, I wanted to keep working but I was too dissatisfied

O

Not applicable, my retirement was mandatory



For the following items, indicate how important each of the following reasons was in your decision to leave your organization. If an item does not apply, mark “Not Important.”



Not Important

Somewhat important

Very important

Personal Reasons




  1. I wanted to change careers

O

O

O

  1. I wanted to run my own business/become an independent consultant

O

O

O

  1. I wanted to further my education

O

O

O

  1. I wanted to pursue non-work interests

O

O

O

  1. I needed to care for another individual

O

O

O

  1. Personal health

O

O

O

  1. Relocate due to transfer of spouse/partner

O

O

O

  1. Relocate for other reasons

O

O

O

  1. Get a job closer to home

O

O

O

  1. Conflict between this job and another

O

O

O










Not Important

Somewhat important

Very important

The Work




  1. Too much work

O

O

O

  1. Unsatisfactory working hours/shifts

O

O

O

  1. Too much job stress

O

O

O

  1. The work was not meaningful to me

O

O

O

  1. My job did not make good use of my skills and abilities

O

O

O

  1. Lack of receptiveness to creativity and innovation

O

O

O

Opportunities




  1. Insufficient opportunity to make a difference

O

O

O

  1. Lack of opportunity to participate in decision-making

O

O

O

  1. Lack of training and career development

O

O

O

  1. Limited opportunities for advancement

O

O

O

  1. Lack of coaching and feedback

O

O

O

Pay and Benefits




  1. Insufficient pay

O

O

O

  1. Unsatisfactory benefits

O

O

O

  1. Insufficient support for continuing education

O

O

O

  1. Lack of support for my family/personal life responsibilities

O

O

O

  1. Lack of flexible work arrangements/telework

O

O

O

Treatment




  1. Lack of support for diversity

O

O

O

  1. Unfair treatment

O

O

O

  1. Discrimination based on race, ethnic origin, gender, age, disability, or other factors

O

O

O

  1. Unfair performance appraisal

O

O

O

  1. Lack of recognition for my work

O

O

O

The People




  1. Poor working relationship with my coworker(s)

O

O

O

  1. If you were a supervisor: Poor working relationship with my subordinates

O

O

O

  1. Poor working relationship with my supervisor

O

O

O

  1. Lack of trust and confidence in senior leaders (i.e., those above your former supervisor)

O

O

O


































Not Important

Somewhat important

Very important

The Organization




  1. Too much red tape

O

O

O

  1. Concerns about ethical issues

O

O

O

  1. Organization was becoming too political

O

O

O

  1. Disagreement with the organization’s goals and objectives

O

O

O

  1. Poor physical working conditions

O

O

O

  1. Insufficient communication about issues related to my work

O

O

O


  1. Overall, how satisfied were you with your job at the time of your exit?

O

Very Dissatisfied

O

Dissatisfied

O

Neither Satisfied nor Dissatisfied

O

Satisfied

O

Very Satisfied


  1. If possible, would you work for ^Agency^ again?

O

No

O

Maybe

O

Yes


  1. Please describe your most important reason(s) for leaving.





  1. Please describe what [Agency] could have done to keep you from leaving.





PART II – BACKGROUND AND EMPLOYMENT INFORMATION


  1. Did management try to keep you from leaving your organization?

O

No

O

Yes


  1. Where did you work at ^Agency^?

O

Organization A

O

Organization B

O

Organization C

O

Organization D

O

Organization E

O

Organization F


  1. What performance rating (or equivalent) did you receive on your last performance appraisal?

O

Outstanding

O

Exceeds fully successful

O

Fully successful

O

Minimally successful

O

Unacceptable

O

Did not receive a performance rating

O

Don’t know


  1. How long had you worked for ^Agency^?

O

Less than 1 year

O

1 to 3 years

O

4 to 5 years

O

6 to 10 years

O

11 to 15 years

O

16 to 20 years

O

21 to 25 years

O

More than 25 years


  1. How long have you been with the Federal Government (excluding military service)?

O

Less than 1 year

O

1 to 3 years

O

4 to 5 years

O

6 to 10 years

O

11 to 15 years

O

16 to 20 years

O

21 to 25 years

O

More than 25 years


  1. What was your pay grade or equivalent GS-level? (WILL BE CUSTOMIZED FOR AGENCY)


Civilian

O

GS 1 – 8

O

GS 9 – 12

O

GS 13 – 14

O

GS 15 – SES

O

WG/WL/WS 1 – 5

O

WG/WL/WS 6 – 10

O

WG/WL/WS 11 or higher


Military

O

E-1 – E-4

O

E-5 – E-9

O

W-1 – W-4

O

O-1 – O-3

O

O-4 – O-5

O

O-6 or higher


  1. What was your job category? (WILL BE CUSTOMIZED FOR AGENCY)

O

Professional (for example, scientist, engineer, attorney, etc.)

O

Administrative (for example, personnel management, budget, contracting, or procurement specialist, etc.)

O

Technician

O

Clerical (for example, support staff, executive secretary, etc.)

O

Wage Grade

O

Other


  1. What was your level of supervisory responsibility?

O

Non-Supervisor

O

Team Leader

O

First-Line Supervisor

O

Manager

O

Executive



  1. What is the highest level of education that you have completed?

O

Less than high school graduate

O

High school diploma or GED

O

Technical, vocational, or business school

O

2-year associate degree

O

Bachelor's degree (B.A., B.S., or other)

O

Master's degree

O

Doctorate degree (Ph.D., M.D., Ed.D., J.D., etc.)

O

Post-doctoral study



  1. What is your age?

O

Less than 20

O

20 – 29

O

30 – 39

O

40 – 49

O

50 – 55

O

56 – 60

O

Over 60



  1. Are you male or female?

O

Male

O

Female


  1. How would you describe your racial or ethnic background? (Select one or more)

O

White (Non-Hispanic)

O

Black (Non-Hispanic)

O

American Indian or Alaska Native

O

Asian or Pacific Islander

O

Hispanic or Latino

O

Other



Center for Talent Services, U.S. Office of Personnel Management 7

File Typeapplication/msword
AuthorSteve Burnkrant
Last Modified ByMEWindsor
File Modified2009-05-08
File Created2009-05-08

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