To:  Full-time Employees Who Have Voluntarily Left University Employment
 From:  Office of Equal Opportunity and Affirmative Action
 Re:  Exit Interview Program

     The University operates an exit interview program for those employees who leave their job voluntarily. This program is designed to identify and correct certain employment problems at Columbia that could cause valued employees to want to leave. We are specifically interested in problems related to race, color, religion, sex, age, national origin, creed, disability, sexual orientation, status as a disabled or Vietnam era veteran or marital status.

     The following is a questionnaire form on which you may explain the reasons for terminating your employment. Although participation in the exit interview program is entirely voluntary, we urge you to complete the form and submit it to us electronically if there are issues you would like to share with us.

     Should you wish to personally discuss your reasons for leaving the University, we would be pleased to speak with you either at our office or over the telephone. You may contact our office (212) 854-5511 during regular business hours.

     Thank you for your cooperation.


Name: 

Social Security Number: 

Department or Division: 

Job Title: 

Approximate Dates of Service: 

Please describe the reasons for your choice to leave your position at the University: