Alternate Work Location/Flexible Scheduling Request Form WF

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Instructions

The following represents an agreement that governs the activities performed while working at an alternate location or flexible schedule as an employee of Lamar University. This agreement is subject to the approval of the employee’s supervisor and the department. During the remote or hybrid period, the employee is still subject to all applicable institutional and departmental policies and procedures, including the rules in Lamar University Policy 2.19.1.

Please note that 1) the agreement period cannot exceed 6 months, 2) a new agreement is required if the alternate work location changes or the nature of your work changes during the remote or hybrid period and 3) Lamar has the right to terminate an Alternate Work Location/Flexible Scheduling Agreement at any time.

If you have any questions please contact HR at (409) 880-8375.

Employee Information

Employee Full Name*

First Name

Last Name

Lamar ID (L#)*

Position Title*

FLSA Status (Salary Type)*

Department*

Lamar email*

Work Phone #*

Alternate Phone #*

Supervisor's LEA Email*

EX: jrdoe@lamar.edu

Supervisor Name*

I am requesting...*

an Alternate Work Location Flexible Scheduling

Alternate Work Location Details

Will you be traveling out of the country during the AWL agreement period?*

No Yes

Country where you will be working during the AWL period:*

How long will you be working out of the country?*

Will you be working out of state during the AWL agreement period?*

No Yes

State where you will be working during the AWL period:*

How long will you be working out of the state?*

Enter the start and end dates for the agreement. Please note that the duration of the AWL agreement period cannot exceed 6 months. On the end date, the agreement will either be terminated or renegotiated for an additional period of time as specified in a new agreement. The department will review the agreement after 30 days and on a periodic basis. Lamar University has the right to terminate an AWL agreement at any time by giving a 30-day notice, when possible.

Start Date*

End Date*

Is this request in conjunction with or related to a need for a temporary job modification or permanent job accommodation due to a medical condition?*

Yes No

A notification will be sent to Leave Management in Human Resources for approval in addition to your supervisor.

Alternate Work Location Address

Please provide the address of the alternative work location you are requesting. Please be advised that a new agreement is required if the address of the alternative work location changes during the agreement period.

Alternative Work Location*

Address Line 1

Address Line 2

City

State

ZIP Code

Country

Phone*

Will the department need to provide you with any computer equipment to perform your job duties?*

Yes No

Describe equipment needed*

Are there any job duties that you will be unable to perform as a result of an AWL agreement that will need to be completed onsite by another employee?*

Yes No

Describe job duties that will need to be performed onsite by another employee*

Alternate Work Location/Flexible Schedule Conditions

Please review the following conditions of AWL/FS arrangements:

Lamar University has the right to refuse to make AWL/FS arrangements available to an employee and to terminate an AWL/FS agreement at any time. Under most circumstances, a reasonable notice period of 30 calendar days should be provided.

AWL/FS agreements do not change the terms and conditions of employment, salary, job responsibilities or benefits including paid holidays. These agreements do not constitute an employment contract and do not create a property interest in employment.

Proposed AWL/FS agreements involving non-exempt, out-of-state, or international employees should be discussed with Human Resources and Payroll Services before approval to identify possible overtime, compensatory time, and tax implications in advance.

AWL/FS agreements may also be considered on a case-by-case basis as a reasonable accommodation for qualified employees with disabilities. Specific conditions and approval processes are outlined in Lamar University Policies Section 6.

The approval of an employee’s AWL/FS agreement does not mean that an employee who subsequently fills that same position will be authorized to participate in an AWL/FS agreement. Vacant positions actively being recruited must indicate whether the position is eligible for AWL/FS arrangements.

The work location identified in an AWL/FS agreement must be free of distractions. Employees are responsible for maintaining a designated workspace in a clean, professional, and safe condition at the designated work location specified in the AWL/FS agreement.

AWL/FS agreements are not intended to serve as a routine substitute for child or adult care.

By signing this agreement, you are certifying that you have entered accurate information and have read and understand all terms and conditions set forth in the policies and conditions of employment under the Alternate Work Location/Flexible Schedule Agreement.

Employee signature is required. Indicate your preferred format.*

Typed name serves as signature Sign using mouse

Typed name serves as employee signature*

Employee Signature*

[clear]

Use your mouse to draw your signature above

Supervisor Approval

Is employee's request approved?*

Yes No

Please give reasons/comments why the request was not approved.*

Describe how AWL/FS will support the department's business needs and how it will benefit LU.*

Describe method of communication to be used between employee/supervisor.*

Describe how department will measure employee's productivity/outcomes.*

Will the department be issuing any equipment to the employee for use at the alternate location?*

Yes No

Provide description including list of equipment being provided.*

Instructions

Employee Information

Alternate Work Location Details

Alternate Work Location Address

Proposed Work Schedule

Alternate Work Location/Flexible Schedule Conditions

Supervisor Approval