Employee Written Warning Notice - Umchs

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Employee Written Warning Notice
Employee Information
Employee Name:
Date:
Type of Warning
First Warning (Verbal Warning Date: _______)
Second Warning (First Warning Date: _______)
Type of Offense
Violation Date: _____________________
Tardiness/Leaving Early
Attendance
Violation of Company Policies
Work Quality
Violation Time: (a.m. / p.m.): __________________
Violation of Safety Rules
Disobedience
Place Violation Occurred: _____________________
Other: ______________________
Specific rule violation or performance problem:
Specific change in the employee’s performance or behavior that is expected and timeline for change::
Consequences of Further Infractions:
Employee’s comments:
Supervisor’s comments:
Acknowledgement of Receipt of Warning
By signing this form, you confirm that you understand the information in this warning. You also confirm that you and your
supervisor have discussed the warning and a plan for improvement.
Employee Signature
Date
Employee was asked to sign this written warning on ___________ but refused to sign.
Supervisor Signature
Date
**This written warning does not alter the at-will employment relationship**

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