Employee warning notice
Employee name _____________________________________________
Type of violation
Attendance
Lateness/leaving early
Rudeness to employees/customers
Unsatisfactory work quality
or procedures
Carelessness
Failure to follow instructions
Willful damage to material/equipment
Violation of company policies
Previous warnings (Please note the date.)
Oral
___________________
1st warning
___________________
2nd warning
___________________
3rd warning
Employer statement
Date of incident _________ Time _________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
Written
___________________
___________________
___________________
Insubordination
Violation of safety rules
Working on personal matters
Other: ___________________
Delivered by whom?
___________________
___________________
___________________
Employee statement
I agree with my employers statement
I disagree with my employers description of the violation.
The reasons are ____________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Action to be taken:
Warning
Probation
Suspension
Dismissal
Other________________________________________________________________________________________________
Corrective action to be taken:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Consequences 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: _______________________