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DISCIPLINARY
NOTICE
Employee_____________________________________
Department____________________________________
_____ Written Warning _____ Final Warning
1. Statement of the problem:______________________________________
___________________________________________________________
___________________________________________________________
2. Prior discussion or warnings on this subject, wherther oral
or
written:_____________________________________________________
___________________________________________________________
3. Company policy on this subject:________________________________
___________________________________________________________
___________________________________________________________
4. Summary of corrective action to be taken by the Company and/or
employee:___________________________________________________
___________________________________________________________
5. Consequences of failure to improve performance or correct
behavior:______________________________________________________
_____________________________________________________________
6. Employee Statement:____________________________________________
_____________________________________________________________
_____________________________________________________________
Employee Signature:___________________________________Date_______
Management Aprroval:__________________________________Date______
Distribution: One copy to Employee, one copy to Supervisor and
original to Personnel File.
