Free employee warning notice 30Free employee warning notice 30Free employee warning notice 30
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OFFICE USE ONLY:
Human Resources rec’d on:

____________

EMPLOYEE COUNSELING/WARNING NOTICE
.

Employee: ______________________________ Position: ______________________ Today’s Date: _________
am

Violation Date: _________ Violation Time: _________
Type of Notice:
Counseling

1
2

pm

Violation Location: _____________________

Final Warning: without suspension

Written Warning

Final Warning: with suspension of _____ days

Written Warning

Discharge recommended

st

nd

Check here if this is in response to a SIRC recommendation ____________
Any infraction of agency policy or practice may result in further disciplinary action including
termination. If the infraction is of a severe nature any or all steps leading to discharge may be waived.

Nature of Deficiency: (Please check)
_____ Insubordination

_____ Training

_____ Attendance/Tardiness/Unauthorized Early Quit

_____ Failure to Follow Directions

_____ Unsatisfactory Work Quality

_____ Violation of Agency’s Policy and Practices