Date: | Department: | |
Title: |
1. Has a verbal warning been given?
2. Type of warning
_____________________________________________________________________________________
_____________________________________________________________________________________
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TO BE READ AND SIGNED BY THE EMPLOYEE:
The above problem(s) have been discussed with me, and I understand that failure to improve my performance or additional unsatisfactory behavior will result in further disciplinary action, up to and including suspension or termination. I understand that my signature does not necessarily signify agreement with the facts or actions stated. If I disagree, it is my option and responsibility to pursue an appeal as follows:
Employee's signature: ________________________________ Date: ____________________
-or-
Employee was asked to sign this written warning on _______________ but declined to sign.
Witnessed by: ________________________________________ Date: ____________________
Name:
Title:
Supervisor's signature: _______________________________________ Date: _____________