Alternate Work Schedule Request

The alternate work schedule allows employees and supervisors to mutually agree upon a varied distribution of their normal work hours. It does not change the number of hours worked, but simply allows each individual the flexibility to rearrange their work schedule to better meet their personal needs while also considering the needs of the organization.

Some benefits of an alternate work schedule are:

1. Improved employee morale and job satisfaction;
2. Extended hours of service to the public;
3. Decreased short-term absenteeism (ex: medical and miscellaneous personal appointments); and
4. Increased employee usage of carpools and public transportation.

Use this sample form as an employee request for an alternate work schedule.  Generally, this would be used in organizations with an alternate work schedule policy so that there is a consistent request procedure across the whole organization.

For additional resources, see Alternate Work Schedule - Manager Checklist and Alternate Work Schedule - Samples.  See also Flextime Request Form and Flextime Request Form - Seasonal for alternative forms for flextime arrangements.

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