Associate Name:*

First Name Last Name

Supervisor

Supervisor's Email

Site Location*

Department / Job Title*

Type of Warning:*

Type(s) of Violation:*

Description of Incident | Violation:*

Plan for improvement:*

YOU MUST IMMEDIATELY:

Correct Your Behavior, Follow Company Policies, and Meet Company Expectations

FURTHER VIOLATIONS WILL RESULT IN:

Additional Disciplinary Action Up To And Including Immediate Termination

Associate Please Print Name:

Associate Signature - My signature acknowledges the following: (1) I understand my specific area(s) for improvement as conveyed by my manager and/or IntelliSource representative. (2) By receiving this warning, I acknowledge that my employment with IntelliSource is dependent upon my attendance, performance, and/or professionalism issues that may occur in the future. (3) I understand that IntelliSource practices progressive disciplinary action and should I fail to comply with guidelines, consequences may include termination from assignment and IntelliSource.*

IntelliSource Site Supervisor Signature:*

Date Of Incident:*

Month Day Year

Employee Improvement Form