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: ____________