Remote work request

Formalize remote or hybrid arrangements with days, needed equipment, and commitments.

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Employee name*

First Name

Last Name

Role*

Team or department

Requested arrangement*

Fully remote Hybrid Temporarily remote

Days you would work remotely

Monday Tuesday Wednesday Thursday Friday

Start date*

End date (if temporary)

City and country you'll work from*

Reason and plan to keep up your performance*

Confirm your workspace has:

Stable internet of at least 50 Mbps A quiet space for video calls A proper chair and desk

Do you need additional company equipment?*

Yes No

Equipment you need

Monitor Headset Keyboard and mouse Ergonomic chair Other:

Commitment*

I commit to following the remote work policy and being available during agreed hours.

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