WRITTEN WARNING FORM
(TO BE COMPLETED BY THE MANAGER ISSUING THE WARNING)
NAME OF EMPLOYEE: ........................................................................................................................................................................
REASON FOR WRITTEN WARNING: ……………………………………………………………........................................................................................................................................................................................................................ …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..…………………………………………………………………………………………
DESCRIPTION OF WRITTEN WARNING:----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
DATE OF ISSUE: ......................................................................................................
MANAGER’S SIGNATURE:……………………………………..DATE:……………………………...
EMPLOYEES’S SIGNATURE:…………………………………...DATE:……………………………..
EMPLOYEE REP SIGNATURE:…………………………………DATE:……………………………
(TO BE COMPLETED WITHIN FIVE DAYS OF RECEIVING A WARNING, BY AN EMPLOYEE WHO WISHES TO APPEAL)
I WISH TO APPEAL AGAINST THIS WRITTEN WARNING FOR THE FOLLOWING REASONS:………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
SIGNATURE OF EMPLOYEE:………………………………………..DATE:……………………….
RECEIVED BY MANAGER:
SIGNATURE:........................................................................ DATE: ....................
(TO BE COMPLETED BY THE MANAGER CONSIDERING THE APPEAL)
DATE RECEIVED:……………………………………………………………………………
OUTCOME OF APPEAL:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
SIGNATURE OF MANAGER:............................................. DATE:……………………………………
SIGNATURE OF EMPLOYEE:........................................... DATE:……………………………………..
HEARING FORM
(TO BE COMPLETED BY THE MANAGER CONDUCTING THE HEARING)
- NAME OF EMPLOYEE:.............................................................................................
- NAME OF CHAIRPERSON:...........................................................................................
- SUMMARY OF ALLEGATIONS AGAINST EMPLOYEE:…………………………………................................................................................................................................................................................................ ……………………………………………………………………………………………………………………………………………………………………………………………………...
- DATE AND TIME EMPLOYEE ADVISED OF HEARING TO BE HELD:……………….
- DATE AND TIME OF HEARING:....................................................................................
- PERSONS PRESENT AT HEARING (EXCLUDING WITNESSES) AND THEIR DESIGNATION:………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
7.(a) EMPLOYEE DOES/DOES NOT WISH TO HAVE A REPRESENTATIVE PRESENT (DELETE WHICHEVER DOES NOT APPLY). NAME OF REPRESENTATIVE)………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..
- (b) EMPLOYEE DOES/DOES NOT WISH TO HAVE AN INTERPRETER DELETE WHICHEVER DOES NOT APPLY). NAME OF INTERPRETER…………………………………………………………………………………………………………………………………………………………………………………
- BRIEF SUMMARY OF EMPLOYEE’S RESPONSE TO ALLEGATIONS:
- SUMMARY OF EVIDENCE (STATE NAMES AND DESIGNATIONS OF WITNESSES GIVING THIS EVIDENCE) / ADDITIONAL PAPER TO BE USED IF SUFFICIENT SPACE NOT AVAILABLE ON THIS FORM:
- MANAGER’S FINDINGS, BASED ON THE EVIDENCE PRESENTED:
- RELEVANT FACTORS TO BE TAKEN INTO ACCOUNT IN DECIDING ON THE APPROPRIATE PENALTY:
- OUTCOME OF HEARING:
- MANAGER’S SIGNATURE: ................................................. DATE:
- EMPLOYEE’S SIGNATURE:............................................... DATE:
PART II
(TO BE COMPLETED WITHIN 5 WORKING DAYS OF ACTION HAVING BEEN TAKEN, BY AN EMPLOYEE WHO WISHES TO APPEAL)
I WISH TO APPEAL AGAINST THE OUTCOME OF THE HEARING FOR THE FOLLOWING REASONS:
IN TERMS OF THIS APPEAL, I ASK THAT THE FOLLOWING ACTION BE TAKEN WHEREFORE, I ASK FOR THE FOLLOWING TO BE TAKEN:
EMPLOYEE’S SIGNATURE:........................................... DATE:.............................................
RECEIVED BY MANAGER:
SIGNATURE:............................................................... DATE:.........................................................
PART III
EMPLOYER
(TO BE COMPLETED BY THE MANAGER HEARING THE APPEAL)
DATE RECEIVED:....................................................
FINDINGS CONCERNING THE APPEAL:.............................................................................................
OUTCOME OF APPEAL:
MANAGER’S SIGNATURE:................................................... DATE:
EMPLOYEE’S SIGNATURE:………………………….DATE: