DISCIPLINARY NOTICE Employee Name: ______________________________________________________ First Middle Last Department: ______________________________________________________ _____ Written Warning _____ Final Warning 1. Statement of the problem: ____________________________________________ _________________________________________________________________________ _________________________________________________________________________ 2. Prior discussion or warnings on this subject, whether oral or written: _________________________________________________________________________ _________________________________________________________________________ 3. Company policy on this subject:_______________________________________ _________________________________________________________________________ _________________________________________________________________________ 4. Summary of corrective action to be taken by the Company and/or employee: _________________________________________________________________________ _________________________________________________________________________ 5. Consequences of failure to improve performance or correct behavior: _________________________________________________________________________ _________________________________________________________________________ 6. Employee Statement:________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Employee Signature: __________________________________ Date: ____________ Management Approval: __________________________________ Date: ____________