Form 5500F1 3/16/2020
EMPLOYEE SECTION:
I, __________________________________:
(Name)
1.
Have read the WWCC Remote Work Policy and agree to abide by its provisions.
2.
Will keep my supervisor informed of progress on assignments and any problems
which may be experienced while working remotely.
3.
Will be available to my supervisor, co-workers, students, and the public during
remote work hours via phone, phone messaging and/or e-mail throughout the day.
4.
Will post my remote work days and hours on my Outlook calendar and update my
phone message at work.
5.
Will promptly notify my supervisor of any emergency or other issue that causes me
to be unavailable on the remote work day(s).
6.
Will maintain safe working conditions and practice appropriate safety habits at the
alternative worksite. Immediately notify my supervisor and HR of any injury incurred
while working.
7.
Understand that this Remote Work Agreement may be terminated at any time by
myself or the College.
_____________________________________________ _______________________
Employee Signature Date
*************************************************************************************************************
SUPERVISOR SECTION:
______________________________is authorized to begin a mutually beneficial program of
(Employee)
remote work beginning ___________________.
(Date)
_____________________________________________ _______________________
Supervisor’s Signature Date
_____________________________________________ _______________________
Vice President’s Signature Date
*************************************************************************************************************
HUMAN RESOURCES SECTION:
Approve Deny
_____________________________________________ _______________________
Human Resources Signature Date
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