Full-Time to Part-Time Work Schedule Change Request Form
Submit this form to request a change from full-time to part-time work status. All information will be reviewed by your manager and HR.
Employee Full Name
*
First Name
Last Name
Employee ID
*
Department
*
Please Select
Human Resources
Finance
Operations
Sales
Marketing
IT
Other
Job Title
*
Work Email Address
*
example@example.com
Current Work Schedule (Days/Hours)
*
Requested Part-Time Schedule (Days/Hours)
*
Requested Effective Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Schedule Change
*
Manager's Name
*
Submit Request
Should be Empty: