Employee Reprimand Form
Employee Name
First Name
Last Name
Employee ID
Team
Violation Statement
Date of Violation
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Place of Violation
Please describe the violation in detail.
What are the corrective actions to be taken?
Disciplinary Action
Administrative leave
Recommendation for termination
Sent home
Suspension without pay
Other
Issuing Supervisor
First Name
Last Name
Signature
Submit
Should be Empty: