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Model Disciplinary Warning
| (For Internal Use Only) | |
| Date of Warning: _____ / _____ / ______ | |
| Employee: _________________ | |
| Title: | Department/Location: |
| D/O/H: | Supervisor's Name: |
|
1. State facts regarding warning.
2. State why the alleged acts violate company policy.
3. State whether or not the employee ever received a warning regarding this or prior incidents (if in writing, please attach a copy).
4. Has the incident been discussed with the employee?
5. If so, state employee's reaction.
6. State conclusion (consequences of incident and steps to be taken to correct the problem).
7. Final comments.
| |
| PREPARED BY: | APPROVED BY: |
| ____________________ Name and Title | ____________________ Name and Title Of Supervisor |
| ____________________ Signature | ____________________ Signature Of Supervisor |
| ____________________ Date | ____________________ Date |
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