Telecommuting FormThis application must be completed for each day you are requesting to telecommute. Your Supervisor has the authority to approve or decline each request. If the office has an emergency closing for the day, telecommuting will be suspended unless your supervisor deems the work necessary to the progress of an individual or team assignment. In the event of a delayed opening or early dismissal, you are expected to work your full 7 hours since you are not traveling to and from the office. I agree to this and all policies on this form Name* First Last Today's Date Month Day Year Telecommuting Location Phone Number You Can Be Reached At While TelecommutingWhat Date Are You Requesting To Telecommute MM slash DD slash YYYY What specific project/task are you requesting to work on while telecommuting?What equipment, materials, or files are you requesting to take with you on the day you telecommute?Telecommuters are expected to review and adhere to the Telecommuting Policy as well as all other embrella Policies.All employees are required to clock-in and out on the time management system when telecommuting.Non-exempt staff is not permitted to exceed 7 hours per day without prior permission from the CEO.The work assignment shall be handled and completed in the same manner as non-telecommuter assignments.All telecommuters are required to submit a Telecommuting Report Form to their Supervisors within two days of the telecommuting date. CERTIFICATION: I understand that any telecommuting arrangements must be approved in advance by embrella and it is solely within embrella' discretion to allow me to telecommute. I understand and agree to abide by the terms and conditions of the Telecommuting Policy in the Employee Manual. I also understand that the telecommuting arrangement may be cancelled at any time. I understand that embrella' needs take priority over the telecommuting arrangement and therefore this schedule may be altered to require my presence at my primary workstation at any time. I assure that I will maintain a safe office environment at my remote office location. I also understand that embrella' approval to allow me to telecommute does not alter the status of my at-will employment. Δ
