Employee Counseling Notice printable pdf download

Employee Counseling Notice

Name:________________________________ Date:_____________ Store:

____________

Reason for Counseling (Check all that Apply):

Poor Work Performance

Mishandling of Cash/Merchandise

Alcohol Sale to Minor*

Inaccuracy

Mishandling of Machinery/Property

Tobacco Sale to Minor*

Improper Uniform

Improper Check/Credit Card

Improper/Unsafe Conduct*

Process

Improper Appearance

Excessive Cash in Drawer

Discrimination/EEO Violation*

Low/Poor Output

Tardiness/Lateness (unexcused)

Improper Customer

Relations*

Not Dependable

Improper Telephone Usage

Sexual Harassment*

Uncooperative

Consumption of Merchandise

Failure to ID Alcohol/Tobacco

(unpaid)

Customer*

Failure to Clock in/out

Failure to follow directions

OTHER ________________

*Items in bold may be subject to immediate termination, depending upon the severity of the incident

This is a:

First Warning (Verbal)____ Second Warning (Written)____ Final Warning____ Termination*_____

*Termination requires approval from Director of Human Resources or Regional Manager

Describe the incident, including witnesses, statements, and activity observed/causing counseling:

_______________________________________________________________________________________

Describe the disciplinary action to be taken: (warning, suspension, termination, etc.)

_______________________________________________________________________________________

What will be the future consequences if the behavior/activity is not corrected?

_______________________________________________________________________________________

Other Remarks/Comments:

_______________________________________________________________________________________

___________________________

____________________________ ___________________________

Employee Signature

Manager Signature

District Manager Signature

Effective 7/99

Employee Counseling Notice

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