Employee Remote Work Request Form

Remote Work allows employees to perform a portion of their job responsibilities at an alternate work site while maintaining a full-time employment schedule. The employee’s duties, obligations, responsibilities and conditions of employment with the college remain unchanged when the arrangement involves only a change in work location. Employees may consider remote work for up to two days per work week.

The decision to allow an employee to work remotely is at the discretion of the employee’s success levels of leadership, including the Strategic Leadership Team (SLT) member, and is determined by the nature of the employee’s position and the feasibility of performing the role successfully in an alternate environment. The leader must notify all successive levels of leadership of the employee's request before a decision is made. A remote work arrangement is most appropriate for a position that has clearly defined tasks, measurable work activity, and does not require the employee to be present in the office during all normal business hours.

Employee Responsibilities

  • Maintain accurate time reporting. Exempt employees must document vacation, sick, and personal business leave time in the leave reporting system. Non-exempt employees should document all time worked and leave time in the timekeeping system.
  • Non-exempt employees must obtain prior leadership approval for overtime.
  • Maintain valuable or above on performance evaluations and demonstrate the college values.
  • Remote work is not a substitute for dependent care. Employees with dependents must make arrangements for dependent care during the agreed upon work hours, just as the employee would do if they were working at a College facility. If the College determines that an employee has responsibility for the care of a dependent during work hours, then the remote work arrangement is subject to immediate termination.
  • While working remote, the employee must be accessible via telephone, e-mail or through other communication methods during agreed-upon work hours. The employee must be available for emergency situations and may be asked to return to a College facility on short notice.

Termination/Modification of the Remote Work Arrangement

The employee may request to terminate the remote work arrangement by providing written notice to their leader. When applicable, a two-week notice must be given to allow the leader time to assess operational needs and to make scheduling decisions for the department.

The leader must provide written notice to the employee that the remote work arrangement is being terminated or modified. Notification may be immediate depending on terms and conditions referenced in Remote Work Procedure.

*All Fields Are Required To Be Completed By Leader

Employee Information


Reviewed the remote work procedure with employee
Leader has reviewed the following with the employee
  1. Duration and schedule of the remote work agreement
  2. Methods and expectations of accessibility, communication, and accountability with leadership and co-workers while working remote
  3. Technology requirements: Employee is responsible for providing any technology they do not currently have through the college (e.g. printer, scanner, cell phone, etc.)
  4. Notification of attendance at any required on-site meetings or events
  5. Maintaining the security of work-related materials including documents saved on a computer or taken off-site and safe destruction of confidential work-related documents. Refer to the College’s Information Security Policy and the additional technology-related information within the Remote Work policy.
Employee has submitted plans to leader

Remote Work Information

A Remote Work arrangement may be extended upon review by the leader and next-level leader.

Maximum 2 Days

Leader's Information

This Remote Work arrangement has been approved by the following leaders, including my SLT member:

You must acknowledge and click "Yes" to complete this form.

By clicking Yes, I acknowledge that I have explained the Remote Work Request Procedure to my employee and that my leadership has approved the schedule entered above. * 

I understand that my leaders will receive an email notification of this form and a copy of this notification will be sent to my SLT member. A copy will be kept on file with Payroll and Human Resources.


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