MAKING A REQUEST FOR FLEXIBLE WORKING ARRANGEMENTS CHECKLIST YOUR

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Making a request for flexible working arrangements checklist

Your request must:

Be in writing
Have your name written on the request
Be dated with the day of when your request was made
Show reference to Part 6AA of the Employment Relations Act 2000
Explain the working arrangement you are seeking and whether you want it to be permanent or for a set period of time
State the date that you want the new working arrangement to start and, if the new working arrangement is for a set period of time, and state the date you want the arrangement to end
Explain, in your view, what changes (if any) the employer may need to make to their current business arrangements if the request is approved, eg possible changes to the way the team works together, changes to the physical set up of the workplace etc.

While it is not required, it may be useful to:

Explain why you are requesting a flexible working arrangement , for example, coach a school sports team

Other things to think about:

Keep in mind that a new working arrangement will normally be a permanent change unless otherwise requested and agreed
If your request is approved, you can’t simply revert back to your previous work arrangements without agreement from your employer. You must make another request to your employer
You may have to agree to a reduction in pay if you want your employer to agree to you working fewer hours
If you have workmates or friends who have arranged flexible working hours, ask them about their experiences
How the people you work with will manage if your working arrangement is changed
What effect changing your working arrangement will have on your job
It may be useful to talk with your employer before you apply. This way you can explore what opportunities might be available
You might be able to agree to have a flexible working arrangements trial before the time frame for the formal request starts running
You might wish to discuss with your employer before you take parental leave that you are interested in requesting a flexible working arrangement on your return
If you want the changes to start on your return from parental leave, you should make your request in good time
If in doubt, you might want to discuss a flexible working arrangements trial with your employer.

How to help your employer and yourself:

Be clear about the date you would like your new working arrangement to begin
Give your employer plenty of notice. Your employer must consider and answer your request for flexible working hours in good faith, no later than 1 month from the date of your request. Clarify with your employer about how they like requests to be made, but be sure that everything is in writing. Your employer may have their own form. If you are unsure, use this form
Provide as much detail as possible about the working arrangement you would like. You might also explain why, although this is not required, it may be helpful. and explain why
Show how your plans would not have a negative impact on your employer’s business and may in fact improve it. For example, you might show that you are available to provide extra cover at peak hours to help improve customer service
Identify how the new working arrangement meets your needs, your employer’s needs and the needs of the people you work with
Show how any potential problems your plans may present to your employer can be overcome. For example, you may state that starting half an hour later will have minimal impact on the business as this is the quietest time of the day and you can make it up during the lunch period which is much busier
Check who will consider your request and make sure that you send it to the appropriate person. If the person is away it may be necessary to send it to another manager.

FORM A: Request for Flexible Working Arrangements on the next page is an example of how to put in writing your request for flexible working arrangements.

FORM A: Request for Flexible Working Arrangements

(Type/write your name and address)

To (Use either your employer’s first name or surname)

(Include full name and address)

I would like to request a variation to my current working arrangements under Part 6AA of the Employment Relations Act 2000.

My current working arrangement is:

Place of work: (Give full street address)

Days and hours of work:

Example: Monday to Friday 8.00am to 5.00pm

The working arrangement I would like to have in the future is:

Place of work: (Give full street address)

Days and hours of work:

Example: Monday and Tuesday 8.00am to 1.00pm,

Wednesday to Friday 8.00am to 5.00pm

I would like the new working arrangement to be permanent and commence from:

Example: Monday 1 September 2015

I would like the new working arrangement to be temporary commencing from:

Example: Monday 1 September 2016

and ending on:

Example: Friday 31 October 2016

Optional: Explain the value of the new arrangement.

The new working arrangement will enable me to:

Example: I will be coach the local junior football team on Wednesday afternoons.

The new working arrangement will affect my employer and colleagues in the following way:

Example: I will not be able to work with James on Monday afternoon as I do now.

I think the effect on my employer and colleagues can be dealt with by:

Example: James and I could work together on either Thursday or Friday afternoon.

Personal details

Name:

Staff or payroll number:

Manager:

Signed: Date:

Note to your employer

This is a request for a flexible working arrangement made under Part 6AA of the Employment Relations Act 2000. You must deal with this request within one month of the date you received it.

You can confirm receipt of this request using the attached confirmation slip.

Cut this slip off and return to your employee to confirm your receipt of their request.

Employer’s confirmation of receipt (to be completed and returned to employee)

To:

I confirm that I received your request to change your working arrangement on:

Signed: Date:

You will receive a response to this request within one month.

NOW ATTACH THIS COVERING NOTE TO THE REQUEST FORM AND PASS TO YOUR EMPLOYER

EMPLOYMENT NEW ZEALAND 06/16 Making a request for flexible working arrangements checklist

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