I: Name: Ben El Date: Chicago ID: Title: Department: Supervisor: Flexible Work Arrangement Requested: Other: Begin Date: End Date: Proposed Work Hours: Sun Mon Tue Wed Thu Fri Sat From: To: Answer all applicable questions; otherwise, indicate N/A. How many hours a week will you be working? How many days per week? Which days will be affected by the requested Flexible Work Arrangement? How will your proposed schedule sustain or enhance your ability to accomplish your responsibilities? (Please attach a copy of your job description.) What potential challenges or concerns could the requested Flexible Work Arrangement raise with faculty, colleagues, manager/supervisor, subordinates and others? How do you intend to overcome these challenges? If you are requesting to work off-site/telecommute, are there any aspects of your role that cannot be performed What equipment will be necessary to accommodate this request and who will be providing the equipment (i.e., requestor or department)? And, if applicable, will day care arrangements be made while working off-site? II: This flexible work arrangement request is: Approved Denied If request was denied, please provide explanation.
I: Name: Ben El Date: Chicago ID: Title: Department: Supervisor: Flexible Work Arrangement Requested: Other: Begin Date: End Date: Proposed Work Hours: Sun Mon Tue Wed Thu Fri Sat From: To: Answer all applicable questions; otherwise, indicate N/A. How many hours a week will you be working? How many days per week? Which days will be affected by the requested Flexible Work Arrangement? How will your proposed schedule sustain or enhance your ability to accomplish your responsibilities? (Please attach a copy of your job description.) What potential challenges or concerns could the requested Flexible Work Arrangement raise with faculty, colleagues, manager/supervisor, subordinates and others? How do you intend to overcome these challenges? If you are requesting to work off-site/telecommute, are there any aspects of your role that cannot be performed What equipment will be necessary to accommodate this request and who will be providing the equipment (i.e., requestor or department)? And, if applicable, will day care arrangements be made while working off-site? II: This flexible work arrangement request is: Approved Denied If request was denied, please provide explanation.
BSD_FlexibleWorkArrangement.docx