Employee Warning
To avoid further discipline, employee is expected to
Should this incident occur again you will receive further disciplinary action up to and including termination of
employment.
Employee Response
_________________________________________
__________________________________________
_______________
Issuing Supervisor (Print Name)
Issuing Supervisor Signature
Date
_________________________________________
__________________________________________
_______________
Manager/Director (Print Name)
Manager/Director Signature
Date
_________________________________________
__________________________________________
_______________
Human Resources Director (Print Name)
Human Resources Director Signature
Date
Corrective Probation Period (if applicable):
Effective Dates: _____________ to ______________
Suspension Period (if applicable):
Effective Dates: _____________ to ______________
Paid
Unpaid
Follow-up Meeting (if applicable):
Date: _____________
Employee's signature on this document is acknowledgement that this matter has been discussed with the Employee, and the
Employee has reviewed it prior to its placement in the personnel file.
Employee Signature* __________________________________________________________ Date ___________________
Employee Refused to Sign
* Employee Signature is not required in the case of a Verbal Warning.
Original to be placed in employee's personnel file. Forward to Human Resources Director.
Copy to:
Employee
Supervisor
Director