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Working Hour Adjustment Request
About You
First Name
*
Last Name
*
Your Department
*
Your Position Title
*
About Your Request
Reason for Adjustment
*
Please describe the reason for adjusting your weekly hours.
How many hours are you requesting to work per week?
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If approved, what day would your adjusted weekly hours begin?
*
Is this request to adjust your weekly hours permanent or temporary?
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Is this request to adjust your weekly hours permanent or temporary?
Permanent
Temporary
What you would like your new schedule to look like?
*
Be sure to specify the hours you would like to work for each day of the week. e.g. 9:00 AM – 12:00 PM on Tuesdays
Supporting Documents
Click to choose a file or drag here
Additional Comments or Questions
Submit