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
____________________________
Supervisor’s Signature

_____________________

_______________

Print Name

Date

_____________________

_______________

Print Name

Date