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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
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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
Is this request to adjust your weekly hours permanent or temporary?
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