Worklife Basics | Worklife Programs | For Managers | Worklife Resources | Employee Assistance Program (EAP)

Sample Flexible Work Option Requests

This page provides samples of properly-completed Flexible Work Option Request forms for several types of worklife flexibility.  Although each form is based on an actual request, some information (such as personal identifying information) has been changed or omitted.

You may also wish to obtain a blank copy of the form, and the instructions for completing the form.

• Compressed Work Schedule
• Flexible Work Schedule
• Part-Time Work Schedule
• Job Sharing Arrangement
• Telecommuting Example 1
• Telecommuting Example 2

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Last Updated:  January 24, 2008
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