University of Central Arkansas
Remote Work Request Policy
SCOPE:
This policy applies to all University of Central Arkansas (UCA) staff members and administrators. This policy will be in
effect from June 8, 2020, through August 10, 2020. The University reserves the right, at all times, to modify or to suspend
this policy and/or any alternate or remote work arrangements.
PURPOSE:
UCA recognizes the impact that COVID-19 has had on employees and their ability to physically report to their on-campus
work stations. As UCA begins the process of a phased return to campus beginning on June 8, 2020, there will be a need
for some employees to continue to complete their work assignments with a modified and/or remote work arrangement.
Per the Phased Return to Work guidance that has been outlined by administration, employees that have a work assignment
and/or job function that can be completed off-site may be eligible to continue to work fully or partially from a remote
work location.
Remote work arrangements may not be allowable in all work areas. Although personal needs are a factor in any such
arrangement, University and Departmental requirements remain the primary consideration in setting up an alternative
work arrangement.
PROCEDURE:
An employee may initiate a Remote Work Request by submitting the Remote Work Request form to his or her department
head. The department head, based on the needs of the department and guidance from Human Resources and General
Counsel, will recommend approval or denial of the request. The department head will then provide the form to the
appropriate vice president who will either approve or deny the remote work arrangement request.
Working from home is not a permanent option under this policy. The Remote Work Request form must specify a start and
end date. It is recommended that supervisors approve a remote work plan that lasts from 24 weeks, with the option to
reconsider a new request for remote work upon the expiration of an approved Remote Work Request form.
Remote Work Request
Name:
Date submitted:
UCA email:
Title:
Start date:
End date:
Department head:
Proposed Work Schedule
Start Time
End Time
Lunch Time
Total Hours
Worked
Work Location
(Campus or home)
Monday
Tuesday
Wednesday
Thursday
Friday
Remote Work Assignment
Please list and explain the assignments and activities you will complete while working during this approved remote
work time period. Describe the method you will use to document the completion of all assignments. Attach
additional documentation if needed.
Read the following statements and check each box to indicate agreement:
The employee understands that any additional hours which might involve overtime must be
approved in advance.
The employee agrees that all obligations, responsibilities, terms and conditions of employment
with the University remain unchanged, except those obligations and responsibilities specifically
addressed in this Agreement.
The employee agrees that the University reserves the right to modify or to suspend immediately
this Agreement if it is determined to be in the best interest of the University’s operations.
E
mployee
I hereby affirm by my signature that I have read this Agreement and understand and agree to all of its
provisions.
E
MPLOYEE
S
S
IGNATURE
D
ATE
D
epartment Head:
Recommendation: Approve Deny
D
EPARTMENT
H
EAD
S
S
IGNATURE
D
ATE
Dean (if applicable)
Recommendation: Approve Deny
D
EAN
S
S
IGNATURE
D
ATE
Vice President
Recommendation: Approve Deny
V
ICE
P
RESIDENT
S
S
IGNATURE
D
ATE
A copy of this Agreement is archived in the department personnel file. Revised 4/29/20
Email the completed form to humanresources@uca.edu.
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