APPENDIX G

   VILLAGE OF ORLAND HILLS WRITTEN WARNING REPORT

Date:    

Employee:    

Department:   

Nature of violation:    

         Supervisor Signature:   

Employee:                I concur with above statement

                      I disagree with above statement for the following reasons

Employee Signature:   

Village Administrator Signature:   

Copies:   Personnel

      Village Administrator

      Department

      Employee

(Ord. 89-09, passed 4-12-89)