Minimum Hours Request Form
Submit this form to request approval for a change to your minimum working hours. All fields are required to ensure a complete review.
Full Name
*
First Name
Last Name
Employee ID
*
Department
*
Please Select
Engineering
Product
Design
Customer Success
Sales
Marketing
HR
Finance
Other
Current Minimum Weekly Hours
*
Requested New Minimum Weekly Hours
*
Requested Effective Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Request
*
Manager or Supervisor Name
*
How will this change impact your team or workload?
*
Alternative Arrangements or Additional Comments
Submit Request
Should be Empty: