RECORD OF A DISCIPLINARY ACTION

AND/OR WARNINGS
Name of Employee :
_______________________________________________________________
Employee Number :
________________________________________________________________
Position Held
:_____________________________________________________________________
Date Appointed :
__________________________________________________________________

Referring to Warning No :_______________________________ Dated :

_______________
Nature of Offence :
___________________________________________________________
(e.g. employer has issued a verbal warning).
SIGNED:
EMPLOYER

EMPLOYEE

Warning No :
_________________________
_______________

Dated :

Nature of offence:
(e.g. you are warned that you must conform to the company
regulations. This warning is valid for 3 months from date of this
warning).
SIGNED:

EMPLOYER

EMPLOYEE

Refer Warning No :
________________________
_______________

Dated :

Nature of Offence :
(e.g. please be advised that your conduct / performance is not
acceptable. If you wish to retain your present employment,
improvement is imperative. This warning is valid for a period of 3
months from date of this warning).
SIGNED:
EMPLOYER

EMPLOYEE

NOTE :
Should an employee refuse to sign, request a witness to sign that the
warning has been handed to the employee. The employees signature is
an acknowledgement of receipt of the warning and not an admission of
guilt.