Student Employee Disciplinary Action Form printable pdf download

Student Employee Disciplinary Action Form

Employers, please return a completed form to the Center for Career Services along

with a Student Employee Position Release Form.

** Please provide the student with a copy of this form and retain a copy for your records.

Student Name:

Supervisor Name:

Verbal Warning

Date of Verbal Warning:

I acknowledge that I have given a verbal warning to the student employee and have discussed with the student ways to improve

performance.

Supervisor’s Signature

Date

I acknowledge that I have received a verbal warning from my supervisor and discussed ways to improve performance.

Student’s Signature

Date

Written Warning

Date of Written Warning:

I acknowledge that I have given a written warning to the student employee, have provided a copy of the warning to the student, have

attached a copy of the warning to this form, and have discussed with the student ways to improve performance.

Supervisor’s Signature

Date

I acknowledge that I have received a written warning from my supervisor and discussed ways to improve performance.

Student’s Signature

Date

Termination of Employment

Date of Employment Contract Termination:

I acknowledge that I have terminated the student employee’s contract, have provided a copy of this form to the student, and have sent

this form, the Student Employee Release Form, and the written warning to the Center for Career Services.

Supervisor’s Signature

Date

I acknowledge that I have received notice from my supervisor of the termination of my employment contract.

Student’s Signature

Date

Student Employee Disciplinary Action Form