Free Work From Home Request Form Template
Work From Home Request Form
Please fill out the form below for your request.
Employee Information
Name
Employee ID
Department
Job Title
Phone number
Request Details
Requested Work From Home Date
Reason for Request
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Health Reasons
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Family Care
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Personal Reference
Acknowledgment
Do you have the necessary tools to perform your duties remotely?
Will you be able to attend virtual meetings as required?
Terms & Conditions
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This request is subject to manager approval and may be denied based on business needs.
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Work-from-home days are not guaranteed and should not be considered permanent.
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Employees must ensure they meet performance expectations while working remotely.
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Any changes to work-from-home arrangements must be communicated and approved in advance.
Date:
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