Exit Interview Format(Div)

EXIT INTERVIEW FORM
As you leave us, we would like to ask you to share your perspectives on your work experiences With Diversey. We hope this
information will not only help Diversey India to build on its strengths, but also become more conscious of its needs for improvement in
specific areas. Better understanding the responsibilities of your position will also assist Human Resources to effectively recruit your
replacement. We commit to holding all of your responses in strict confidence and will only use the data gathered in summary reports to
study trends in employee turnover. You may choose to sign this exit interview data sheet if you would like, but it is entirely voluntary.
Employee Name ABHISHEK MISHRA Designation Sr. Territory Manager
Department Sales Supervisor/ Manager Rohit Nagpal
Tier B7 Functional Head Gagan Kulshreshtha
Date of Joining 20-Dec-21 Last Date in Diversey In 22-Sep-22
Eligible for Rehire YES NO
Please Circle one of the following
1 Strongly Agree 2 Agree 3 Neither Agree nor Disagree
5 Strongly Disagree 4 Disagree
1 I enjoyed my work 1 2 3 4 5
2 I was challenged/ motivated by my Job 1 2 3 4 5
3 I was paid fairly for my job 1 2 3 4 5
4 I was given adequate and proper induction 1 2 3 4 5
5 I was given adequate training 1 2 3 4 5
6 I had great physical working conditions 1 2 3 4 5
7 I was recognised for my good work 1 2 3 4 5

My job description accurately reflects the job
8 1 2 3 4 5
responsibilities promised during the offer
9 I was given honest, worthwhile performance appraisals 1 2 3 4 5
10 I was happy with the employee benefits 1 2 3 4 5
11 I had very heavy workload 1 2 3 4 5

Top Management adequately communicated well with
12 1 2 3 4 5
employees
13 I felt there were opportunities for career advancement 1 2 3 4 5
Please tick in the appropriate box

what did you think of your supervisor on the following Almost
1 Always
Usually Sometimes Never
points
a) Was consistently fair & equitable
b) Provided recognition
c) Resolved complaints
d) Was sensitive
e) provided feedback on performance
f) was receptive to open communication
g) provided clear instructions for work assignments and responsibilites
2 How would you rate the following Excellent Good Fair Poor
a) Cooperation within my department

b) Cooperation with other departments
c) Diversey performance review system
d) Diversey induction orientation programme
e) Pay scale within Diversey India
f) Salary structure within Diversey India
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g) Career development/ advancement opportunities
Employee Comments
A) What did you like most about:-
(a) your position

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(b) your department

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(c) Diversey India

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B) What did you like least about:-
(a) your position

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_____________________________________________________________________________________________________
(b) your department

_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
(c) Diversey India

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_____________________________________________________________________________________________________
C) Why are you leaving Diversey?

_____________________________________________________________________________________________________
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D) What circumstances would have prevented your departure?

_____________________________________________________________________________________________________
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E) Were there any company policies or procedures that made your work difficult?
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F) Would consider returning to this company in the future?

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G) Would you recommend Diversey to a friend as a good place to work?
YES NO
H) Would you recommend Diversey as a first choice to a friend as a good place to work?
YES NO
________________________________________ ______________________________________________
HUMAN RESOURCE REPRESENTATIVE EMPLOYEE SIGNATURE
DATE:- ___________________ DATE:- ___________________
Page 2 of 2

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EXIT INTERVIEW FORM

Employee Name ABHISHEK MISHRA Designation Sr. Territory Manager

Department Sales Supervisor/ Manager Rohit Nagpal

Tier B7 Functional Head Gagan Kulshreshtha

Date of Joining 20-Dec-21 Last Date in Diversey In 22-Sep-22

Eligible for Rehire YES NO

Please Circle one of the following

1 Strongly Agree 2 Agree 3 Neither Agree nor Disagree

5 Strongly Disagree 4 Disagree

2 I was challenged/ motivated by my Job 1 2 3 4 5

3 I was paid fairly for my job 1 2 3 4 5

4 I was given adequate and proper induction 1 2 3 4 5

5 I was given adequate training 1 2 3 4 5

6 I had great physical working conditions 1 2 3 4 5

7 I was recognised for my good work 1 2 3 4 5

10 I was happy with the employee benefits 1 2 3 4 5

11 I had very heavy workload 1 2 3 4 5

Please tick in the appropriate box

a) Cooperation within my department

A) What did you like most about:-

(a) your position

(b) your department

(c) Diversey India

B) What did you like least about:-

(a) your position

(b) your department

(c) Diversey India

C) Why are you leaving Diversey?

D) What circumstances would have prevented your departure?

F) Would consider returning to this company in the future?

G) Would you recommend Diversey to a friend as a good place to work?

DATE:- ___________________ DATE:- ___________________

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