Employee Warning Notice

Grand Forks County

151 South 4th Street, PO Box 5726

Grand Forks, ND 58206

Employee Name

Date of Warning

Position

Department

WARNINGS:

Oral

Written

Employer Statement

Date of Incident

Employee Statement

I agree with Employer's statement.

I disagree with Employer's description of violation for these reasons:

EMPLOYEE SIGNATURE

DATE

CORRECTIVE ACTION PLAN:

Action to be taken

Warning

Probation

Suspension

Dismissal

Other

Consequence should incident occur again

I have read this Employee Warning Notice and understand it.

SIGNATURE OF EMPLOYEE

DATE

SIGNATURE OF SUPERVISOR WHO ISSUED WARNING

DATE

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Parent category: Business