EMPLOYEE DISCIPLINE WARNING NOTICE	
Employee Name:      	Employee Number:      	
Job Description:      	Department:      	
Title:      	Date of Notice:      	
Type of Problem	
 Tardiness
 Absenteeism
 Insubordination
 Policy Breach	 Quality of Work
 Quantity of Work
 Neatness
 Language	 Carelessness
 Safety
 Intoxication or Drinking
 Fighting	
 Other:      

Incident Occurred on:	
Date:      
Time:      
Place:      
	 First Notice
 Second Notice
 Other:      
	
Manager Explanation

1. Describe in detail what the employee has done.

2. Cite how this interferes with work environment, employee performance, business operations, or the well-being of other employees or your department.

3. Cite the specific rule, policy, law, standard, or regulation that was violated.

4. Explain in detail what the employee must do to improve performance or change behavior.

5. Cite date that improvements are to be achieved.

6. Cite consequences if improvements are not achieved by date specified.

Note: Attach separate page if needed for more detailed explanations.	
Employee Rebuttal:      

Employee’s Signature:      	Date:      	
Supervisor’s Signature:      	Date: