Exit Interview Form

Human Resource Services

EXIT INTERVIEW FORM

Name: _______________________________________________________________________________

Job Title:

Campus/Department:

Forwarding Street Address:

City:

State:

Zip:

Contact Phone: (_________)

E-Mail: ___________________________________

Please check the appropriate box(es) that indicate your reason(s) for leaving Lake Travis ISD.

___ Personal Circumstances

___Retirement

___Promotion

___ Accepted another position

___Leaving profession

___Moving from the area

___Other (please explain)

Signature

Date

FOR DISTRICT USE ONLY:

Date Exit Interview Received: _______________

3322 Ranch Road 620 South, Austin, Texas 78738 Phone: (512) 533-6000 Fax: (512) 533-6004

email:

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Parent category: Business