EMPLOYEE WARNING NOTICE

Employee name: Date:

Position: Department:

____ First warning ____ Second warning ____ Third warning

Description of problem requiring improvement or correction (include specific dates & examples):

Specific changes in performance or behavior required and the time frame in which they must occur:

Date of follow-up review/evaluation of problem and correction :

Failure of employee to correct problem may result in further disciplinary action up to and including termination of employment.

Employee comments:

Employee signature: Date:

Document if employee declines to comment or sign and obtain witness signature.

Supervisor comments:

Supervisor signature: Date:

Next level of supervision or witness signature:  

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