Find out how to make an effective employee evaluation form

Employee performance evaluation form template

There is a code of ethics that is meant to follow and kept in every organization. Employees are expected to strictly stick to the rules set without breaking any of them. The breaking of rules can cause severe disciplinary action from the company even to the extent of expulsion from work. Disciplinary action is not an easy step either for the company or the individual at fault. Normally an employee will get a few warnings before complete dismissal. Any time one get these warning, your name gets into the record of a disciplinary report. Failure to improve on what you are meant to improve leads you to another warning or a dismissal. It is the employee's duty to ensure that they stay safe by strictly following and keeping to the rules of the company. A disciplinary report must be written down to show the employee's conduct in the organization and to include the number of times the employee has been warned. It is not mandatory for every employer to go through this, it can as well be avoided.

An example of a disciplinary report

A disciplinary report varies depending on different companies. Rules also change and the more reason the punishment or the disciplinary action will vary. You may not receive as many chances as your friend in a different organization. Below is a sample that most companies use.

Employee Discipline Form

Employee Name [...]
Warning Date [...] Warning time [...]
Social Security Number [...]


  • Conduct
  • Breach of company policy
  • Work attendance
  • Failure to follow instructions
  • Creating a disturbance
  • Carelessness
  • Insubordinate
  • Willful damage of the business property
  • Work inaccuracy and low output
  • Unauthorized absence
  • Tardiness
  • Rudeness and foul language to customers, co-workers, and managers
  • Poor productivity with no change


Violation date [...], Violation time [...]

Violations descriptions [...]

Employee Statement [...]

Employer statement [...]

Warning decision [...]

Approved by: [..] date: [..]

Any previous warnings [...] when warned and by whom?

1st warning: Date of the first warning:
Verbal warning employee signature date: Written employee signature date:

2nd warning: Date of the 2nd warning:
Signature of the person who prepared the warning: Written employee signature date:

3rd warning: Supervisor's signature and date [..]

Further violations and misconduct will result in fast disciplinary action that could include immediate termination and a letter of dismissal.

Employee signature: I have read this warning notice and understood it. I agree to bear the consequences of my wrongdoing.


Employee's name and date:

Supervisor's signature and date [...]

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