Leadership Development Cessation Log
Please use this form to document the end of participation in a leadership development program. Your input helps us improve future initiatives.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Leadership Program Name
*
Role or Position in Program
*
Cessation Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Primary Reason for Cessation
*
Completed Program
Personal Reasons
Professional Reasons
Dissatisfaction with Program
Other Opportunity
Other
Please provide additional details about your reason for cessation (if any)
How would you rate your overall experience in the leadership development program?
1
2
3
4
5
What aspects of the program did you find most beneficial?
What aspects of the program could be improved?
Supervisor/Manager Name
Was an exit interview conducted?
Yes
No
Please list any follow-up actions or recommendations for future leadership development initiatives.
Submit Log
Should be Empty: