Employee’s Name: ________________________________ Date: __________________
Department: ______________________________________ Date of Incident: ________
- Has a verbal warning been given?
Yes____ No ____
If yes, date(s) of verbal warning(s) ____________________________
- Type of warning
□ First written warning
□ Final written warning
- Explain why this warning is being given. Check all that apply (Additional information can be provided below).
| □ | Tardiness | □ | Failure to give timely notification of absence | □ | Timecard/time clock violation |
| □ | Excessive absenteeism | □ | Safety violation | □ | Unauthorized overtime |
| □ | Poor job performance | □ | Insubordination | □ | Under the influence of drugs/alcohol |
| □ | Personal business/conversation during work | □ | Sexual harassment | □ | Intentional or negligent damage to company property |
| □ | Physical or verbal assault/fighting | □ | Unauthorized removal of company property | □ | Failure to get along with fellow employees…. |
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