Employee Warning Notice
PLEASE PRINT
Employee Name
Date of Warning
Employee Title
Department
Type of Violation
Attendance
Insubordination
Failure to Follow Instructions
Rudeness to Employees or Students
Violation of MCTC Policies
Unsatisfactory Work Quality
Violation of MCTC Procedures
Willful Damages to Material or
Equipment
Working on Personal Matters
(Computers/E-mail/Cell Phone)
Other
Previous Warnings
ORAL
WRITTEN
DATE
BY WHOM
1
st
Warning
2
nd
Warning
3
rd
Warning
Employer Statement
Employee Statement
AM
Date of Incident _ ____ _/__ ___/_______ Time ___ __:___ _ PM
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
I agree with Employer’s statement.
I disagree with Employer’s description of violation for these
reasons:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Action to be taken:
Warning
Probation
Suspension
Dismissal
Other ________________________
Consequence 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
Distribution: Original HR, Employee Development & Payroll (personnel file), copy (employee and supervisor)
A State Community and Technical College of West VirginiaAn Equal Opportunity/Affirmative Action Employer