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You are here: Home > Resources > Employee Exit/Transfer Interview Form

Info

Employee Exit/Transfer Interview Form

Date

/ /

Name

Your E-Mail Address ■

1. Would you like your answers to be kept confidential to the extent permitted by law? ■

Please select "No" if you want them shared with department/unit heads.

Yes
No

2. Period of Employment:

(Write number of years please.)

3. I am:

Retiring
Leaving UW Oshkosh
Transferring to another unit/department

4. Employment category (check as many as are applicable): ■

To select more than one category hold down the Ctrl button.

5. Name of Department/Unit

6. Your Age

20-29
30-39
40-49
50-59
60-69
70+

7. Your Gender

Male
Female

8. Racial/Ethnic group with which you identify:

American Indian/Alaska Native
Asian
Black/African American
Hispanic or Latino
Native Hawaiian/Other Pacific Islander
White
Other

If other, please specify:

9. Do you have a disability?

Yes
No

10. Which of the following factors first caused you to look for another position or consider retirement (check as many as are applicable):

To select more than one category hold down the Ctrl button. Please select at least one.

If other, please specify:

11. Please elaborate on any of the factors checked in # 10 above

12. Remembering back to when you first were offered this position, what most attracted you about working at UW Oshkosh?

13. If you were a member of the administration and things were implemented as you believed they should, what would the workplace environment look like?

14. What advice would you give to the person replacing you?

15. How do the opportunities offered at UW Oshkosh provide impetus for personal and professional growth? Please fill in.

16. UW Oshkosh's mission is to honor and respect diversity. Do you feel this was reflected in your experience here? Please fill in.

17. What would have persuaded you to stay in this position?

18. When you reflect on your time with UW Oshkosh, what are your distinctive memories? Please fill in.

by Clark, Leslie A. — last modified Oct 06, 2011 04:59 PM

News: Guidance on Complying with Executive Order 54 Oct 10, 2012; Title IX Website Coming Soon! Jun 21, 2012; More…

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