Clear Creek ISD Exit Survey Form

Employee Information

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* Last name

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* First name

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* Initial

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* Address

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* City

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* State

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* Zip

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* Employee ID Number

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* Location/Campus

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* Position

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* Department

Teacher/Instruction

Librarian

Counselor

Maintenance

Transportation

Technology

Paraprofessional

Administration

Child Nutrition

Other (please specify)

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* Nature of Separation
(Please check all appropriate boxes)

Certification Reasons

Personal/Family Obligations

Pursuit of Career outside of education

Retirement (TRS)

Termination

Transferring to employment in another neighboring school district

To which district are you transferring?

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* How many years of experience do you have in CCISD?

1 year

2-3 years

4-5 years

6-10 years

11-15 years

16-20 years

21-25 years

26-30 years

31-35 years

Over 35 years

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* If you are taking employment in another neighboring school district, please indicate a corresponding reason below.

Promotion

Pay Increase

Commute

District Benefits

Working Conditions

District support or mentoring

I am not taking employment in a neighboring district

Other

Please explain "other"

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* How would you rate your experience in Clear Creek ISD in the following areas?

	Poor	Below Average	Average	Above Average	Excellent
Working relationship with supervisor	Working relationship with supervisor Poor	Working relationship with supervisor Below Average	Working relationship with supervisor Average	Working relationship with supervisor Above Average	Working relationship with supervisor Excellent
Campus support and mentoring	Campus support and mentoring Poor	Campus support and mentoring Below Average	Campus support and mentoring Average	Campus support and mentoring Above Average	Campus support and mentoring Excellent
Employee benefits and salary	Employee benefits and salary Poor	Employee benefits and salary Below Average	Employee benefits and salary Average	Employee benefits and salary Above Average	Employee benefits and salary Excellent
Professional Development opportunities	Professional Development opportunities Poor	Professional Development opportunities Below Average	Professional Development opportunities Average	Professional Development opportunities Above Average	Professional Development opportunities Excellent
District resources	District resources Poor	District resources Below Average	District resources Average	District resources Above Average	District resources Excellent
Evaluation procedures	Evaluation procedures Poor	Evaluation procedures Below Average	Evaluation procedures Average	Evaluation procedures Above Average	Evaluation procedures Excellent
Opportunity for advancement	Opportunity for advancement Poor	Opportunity for advancement Below Average	Opportunity for advancement Average	Opportunity for advancement Above Average	Opportunity for advancement Excellent
Administrative support	Administrative support Poor	Administrative support Below Average	Administrative support Average	Administrative support Above Average	Administrative support Excellent
Overall CCISD experience	Overall CCISD experience Poor	Overall CCISD experience Below Average	Overall CCISD experience Average	Overall CCISD experience Above Average	Overall CCISD experience Excellent

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* Additional comments:

If you are moving to a district that uses Eduphoria Workshop, you may request your Professional Learning portfolio be directly uploaded to their system by completing the form at Professional Learning Records Request: https://forms.office.com/Pages/ResponsePage.aspx?id=z39lBzW9mUaVLZ0xfCXs-djOtnrvooFOnSODRhWzROJURVYyMVFONFNEOE1RQzhHWFVRNEtMNlNEOC4u&wdLOR=c9F2A0347-2359-44CB-8FB8-7747F33D20AE

You may also find this form at http://ccisd.net/departments/curriculum-instruction/professional-learning

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* Last name

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* First name

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* Initial

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* Address

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* City

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* State

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* Zip

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* Employee ID Number

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* Location/Campus

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* Position

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* Department

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* Nature of Separation(Please check all appropriate boxes)

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* How many years of experience do you have in CCISD?

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* If you are taking employment in another neighboring school district, please indicate a corresponding reason below.

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* How would you rate your experience in Clear Creek ISD in the following areas?

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* Additional comments:

* Nature of Separation
(Please check all appropriate boxes)