Employee Warning Form
Employee’s Name: ___________________________ Date: ______________
Manager/Supervisor’s Name: _________________________
If previous discipline meeting occurred, enter date: _______________
Reasons for Warning:
____ Absenteeism ____ Failure to follow procedure ____ Rudeness
____ Tardiness ____ Failure to meet performance ____ Refusal to work overtime
____ Policy violation ____ Fighting ____ Language
____ Other _______________________
Details of actions that warranted this warning:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
The following immediate and sustained corrective action must be taken by the employee.
Failure to do so will result in further disciplinary action up to and including termination:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Note: Your signature on this form means that we have discussed the situation. It doesn’t
necessarily mean you agree that the infraction occurred.
____________________________ _____________________ _______________
Employee’s Signature Print Name Date
____________________________ _____________________ _______________
Supervisor’s Signature Print Name Date
