Employee Write-Up
Employee Name:
*
First Name
Last Name
Job Title:
*
Date of submission:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Supervisor Submitting Write-Up:
*
First Name
Last Name
Reason for Write-Up:
*
Failure to use software
Tardiness / Leaving work early
Substandard quality of work
Absenteeism
Violation of safety rules
Violation of company policies
Failure to follow procedures
Rude behavior directed at customers or co-workers
Damage, misuse, or poor treatment of equipment
Out of uniform / PPE
Other
Description of Incident:
*
Cost of damage / incident:
Consequence of incident:
*
Verbal warning
Further unpaid training
1st write-up
2nd write-up
Unpaid day off
Remainder of the week suspended without pay
1 week suspension without pay
2 week suspension without pay
Termination
Plan for improvement:
Consequence of further incidents
*
Further unpaid training
1st write-up
2nd write-up
Unpaid day off
Remainder of the week suspended without pay
1 week suspension without pay
2 week suspension without pay
Termination
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