Fillable Uni Omaha COVID-19 Alternative Work Arrangement Request Form

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Uni Omaha COVID-19 Alternative Work Arrangement Request Form

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The Uni Omaha COVID-19 Alternative Work Arrangement Request Form form is 1 page long and contains:

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  • 12 other fields

Country of origin: US
File type: PDF

U.S.A. forms for University of Nebraska, Omaha

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COVID-19 Alternative Work Arrangement Request Form
Employee’s Name
NUID
Department
Home/Cell phone
Work email
Home email
Normal
Work Days/Hours
Requested
Work Days/Hours
Requested Start Date
Requested End Date
Alternate Work Site
location (address)
Alternate Work Duties requested
(e.g. same duties, or alternate duties requested)
Employee’s Signature
Date:
Immediate Supervisor’s Signature for Approval
Date:
Attach Alternative Work Site Agreement or other Alternative work schedule/duties document
Copies to:
• Employee
• Supervisor
• Employee Personnel File
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Uni Omaha COVID-19 Alternative Work Arrangement Request Form

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Completed 29 March 2020

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