Rev 7/30/2015
Student Employee Disciplinary Action Form
Student Employee’s University ID#
Disciplinary Action: Verbal Warning Written Warning Final Warning Termination
Behavior(s) Subject to Disciplinary Actions:
Employee does not follow directions or does not complete assigned tasks.
Employee is late for a scheduled shift without notification
Employee leaves a scheduled work shift without notifying a supervisor.
Employee does not comply with departmental dress code.
Employee is found to be doing non-related functions while on the clock without permission.
Unsatisfactory work performance by employee.
Employee is found to be exhibiting cruel, harassing, or demeaning behavior towards another
employee.*
Employee is using tobacco, alcohol, or illegal substances while on the clock.*
Employee is insulting, arguing, or using profane language in the presence of customers, UWG
Officials, or other employees.
Employee repeatedly fails to clock in/out.
Misuse, negligence, malicious destruction, or theft of University property.*
Misuse of time clock system (Example: clocking in for hours not worked)
Assault of another employee or customer.*
Willful disobedience, insubordination, intentional refusal, or failure to carry out reasonable
assignments or instructions. *
*Gross misconduct is an action that can result in immediate dismissal. Items with an (*) are just a few that are indicated
as gross misconduct.
Supervisor Comments:
Student Employee Comments:
I have received this disciplinary action and understand that unless I take corrective action, further disciplinary action
will be issued up to and including termination of my employment.
Student Employee’s Signature:______________________________________ Date:_____________________________
Supervisor’s Signature:_____________________________________________ Date:____________________________
