Disciplinary Notice

DISCIPLINARY NOTICE

 

Employee Name:         ______________________________________________________

                                    First                     Middle                           Last

 

Department:                 ______________________________________________________

 

                                    _____ Written Warning            _____ Final Warning

 

1.         Statement of the problem: ____________________________________________

 

_________________________________________________________________________

 

_________________________________________________________________________

 

2.         Prior discussion or warnings on this subject, whether oral or written:

_________________________________________________________________________

 

_________________________________________________________________________

 

3.         Company policy on this subject:_______________________________________

 

_________________________________________________________________________

 

_________________________________________________________________________

 

4.         Summary of corrective action to be taken by the Company and/or employee:

_________________________________________________________________________

_________________________________________________________________________

 

5.         Consequences of failure to improve performance or correct behavior:

 

_________________________________________________________________________

 

_________________________________________________________________________

 

6.         Employee Statement:________________________________________________

 

_________________________________________________________________________

 

_________________________________________________________________________

 

Employee Signature:      __________________________________       Date: ____________

 

Management Approval: __________________________________       Date: ____________

 

Distribution: One copy to Employee, one copy to Supervisor, and original to Personnel File.