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Request to Work from Home - Template, Sample Form

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Dear Sir/Madam,

RE: REQUEST FOR A REMOTE WORKING ARRANGEMENT

I am writing to request a flexible and remote working arrangement due to the following reason:

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I have been working with you as: ________ for the following period: ________. I am currently working as a full-time employee within the following work schedule:

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However, I would like to work from home for ________.

Also, I am requesting that my work schedule be modified as follows:

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Yours faithfully,





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Fields you complete are inserted into the document live. This template is general guidance only - not legal advice.