Employee Warning / Disciplinary Form

Company Name

Name of Employee______

Department:______

Type of Warning

___First warning ___Second Warning

___Third Warning ___Probationary Warning

___Termination ___Voluntary Quit

Employer Comments:

State here the reason for the warning and be as explicit as possible (use additional pages if necessary). Make sure you include exactly what is to be done as a result of this warning including probationary length, termination or if the employee voluntarily quits.

Employee Comments:

Give the employee ample time to write any comments and also offer them additional pages if they ask.

I, ______, hereby state that I have received a copy of this written warning / discipline form on this ___ day of ______, 2010. Employee Signature Date

Supervisor Signature Date

Witness Signature (Optional) Date