(i) CALIFORNIA STATE UNIVERSITY , CHICO
RETURN TO CAMPUS FORM - PART 1
Instructions / Employee Review
PART 1 - Employees Requested to Return to Campus
Department to submit Part 1 for VP/Dean approval.
1) List all employees requested to return to campus in Summer and/or Fall on a full-time or partial-time basis and the estimated hours/
days requested to be on-campus.
2) Include information that explains the reason the employee(s) need to return to campus and why the services cannot be performed
remotely, or academic space must be used.
3) Employees 65 and older, as well as those with serious underlying medical conditions (as defined by the CDC), may be invited back to
campus to work. Employees who are unable to return to campus should contact the Benefits unit in the Human Resources Service
Center to explore available options by emailing firstname.lastname@example.org or calling (530) 898-4360.
Summer 2020 Plan Fall 2020 Plan
(to assign training)
Estimate days/hours per week
Reason why services cannot be performed
remotely or academic space must be used
Use multiple lines if needed
Example – John Doe 07 X X Summer: Mon‐Wed – 8am to noon Need access to documents and files in office for
Example – Dr Jane Doe 03 X X Summer: Mon‐Th – 7am to noon Need access to chemicals and scientific equipment
Example – Student Asst n/a X X Summer: M/W – as needed Need to feed animals
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Additional information may be attached if necessary.
Environmental Health and Safety