Employee Corrective Action Form - Florida - Edit, Fill, Sign Online

Revised 03/01/2013

Employee Name: _____________________________________________ Date: ___________________

Department: ________________________________ Job Title __________________________________

Verbal Counseling______________ Verbal Warning ______________ Written Warning______________

Give date, time, and place given __________________________________________________________

The above disciplinary action was taken against you for:

Disciplinary Action: (

Give a statement of the facts causing this action, including time and place, acts and names of persons involved)

_____________________________________________________________________________________

Action Plan:

1) ___________________________________________________________________________________

2) ___________________________________________________________________________________

3) ___________________________________________________________________________________

I delivered a copy of this form to the subject employee on ____________________________________

Date

__________________________________________ __________

Employee’s Signature Date

___________________________________________ __________

Supervisor’s Signature Date

___________________________________________ __________

Manager’s Signature Date

I am aware that a copy of this notice will be placed in my personnel file.

BETHUNE-COOKMAN UNIVERSITY

EMPLOYEE CORRECTIVE ACTION FORM

____Absenteeism ____Tardiness ___Misuse/Damage of University Property ___Negligence

___Leaving Work Area W/O Permission ___Failure to Complete Assigned Duties ___Poor Performance

___Insubordination ___Use of Profane or Abusive Language ___Conduct Unbecoming

___Violation of Safety Rules ___Failure to Comply with Issued Directives ___Other

Fillable Printable Employee Corrective Action Form - Florida