Fillable Employee Corrective Action Notice Form (SOWELA Technical Community College)

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Employee Corrective Action Notice Form (SOWELA Technical Community College)

On average this form takes 14 minutes to complete

The Employee Corrective Action Notice Form (SOWELA Technical Community College) form is 1 page long and contains:

  • 4 signatures
  • 16 check-boxes
  • 33 other fields

Country of origin: US
File type: PDF

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EMPLOYEE CORRECTIVE ACTION NOTICE FORM
Employee Name Work Location / Position Date of Discipline Action Given
Employee ID # Date of Occurrence Supervisor Issuing Action
Performance Feedback Level:
Suspension Pending Investigation
Verbal Suspension Pending Investigation
Written
With Pay (_____ Days) Without Pay (_____ Days)
Termination
Please check appropriate reason for performance discussion:
Damage to Property
Violation of Company Policy/Procedure
Indicate Policy:
Falsification of Documents
Conduct
Safety/Carelessness Inappropriate/Abusive Language
Harassment Insubordination Other
Yes No
Has Employee received prevous performance feedback for this or related issues?
If yes, list dates, level and violation of previouse performance feedback:
Facts:
(Specific description of incident, attach any supporting documentation)
Date of incident:
Location of incident:
Facts related to incident:
Corrective Actions to be Taken:
Corrective Actions/Timeframe:
Consequences of Failure to Improve:
Consequences/Timeframe:
Acknowledgement:
The above has been discussed with me by my supervisor. I understand the contents and acknowledge and understand the corrective action required. I
also acknowledge and understand the potential consequences of noncompliance.
Employee refused to sign this form and all attached documentation.
Employee Statement:
If any additional occurrence of a similar nature occures, further corrective action/counseling will occur, which can include termination of employment.
Employee's Signature Date Supervisor's Signature Date
Witness' Signature Date HR Signature Date
The above disciplinary action has been noted and this form will be made part of the above employee's permanent file, as of this date.
HR Form Created 04/26/2019
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Employee Corrective Action Notice Form (SOWELA Technical Community College)

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Completed 17 September 2020

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