DISCIPLINARY NOTICE

□ Written Warning □ Verbal Warning

Employee Name : _________________________________________________Date : ________________

Supervisor Name : ______________________________________________________________________

Misconduct : □ Serious □ Very Serious □ Inexcusable

Description of Misconduct :_______________________________________________________________

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Has employee been warned about this previously? □ No □ Yes Date ______________
If yes, describe how :

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Consequences of failure to improve performance or correct behavior :

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Describe corrective action to be taken by employee (attach written plan) :

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Employee Signature _________________________________________ Date ______________________

Employer Signature _________________________________________ Date ______________________