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1. At approximately what point in time did you begin making your decision to resign?

If other, please specify:

2. Please indicate reason(s) below, which contributed to your decision to resign your current position?

If other, please specify:

3. Was there a specific event of issue that prompted your resignation?

If yes, please briefly explain:

If yes, did you discuss this matter with your supervisor/manager?

4. Quantity and quality of training received for your position(s) here at Blue Stone.

5. Working relationship with your current supervisor.

6. Working relationship with fellow employees.

7. Salary for your position

8. Employee Benefits package

Please offer any comments or suggestions for improvement related to the Benefits package.

9. Overall workload for your position.

10. Overall satisfaction and enjoyment in your current position.

11. Did you encounter any problems in your current position?

If yes, please briefly comment: :

12. What did you enjoy most about your employment with Blue Stone?

13. Based upon your experiences here, would you recommend Blue Stone as a potential employer for your friends, relatives, etc.?

If no, please briefly explain:

14. Would you reapply to Blue Stone if a future opportunity arose

If no, please briefly explain:

Please add any additional comments

Please fill your name and position