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  • Flexible Work Application and Agreement Form

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    Suganthi Aravind
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    Suganthi Chandrasekaran, a manager at ATCI, has applied for a part-time flexible work arrangement working 20 hours per week. She provides her contact information for working remotely from her home in Gurgaon, Haryana. The reason for her request is to support her daughter who has had a kidney transplant and requires treatment and support. By signing, she agrees her terms and conditions of employment remain unchanged under this flexible work arrangement.

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    Suganthi Chandrasekaran, a manager at ATCI, has applied for a part-time flexible work arrangement working 20 hours per week. She provides her contact information for working remotely from her home in Gurgaon, Haryana. The reason for her request is to support her daughter who has had a kidney transplant and requires treatment and support. By signing, she agrees her terms and conditions of employment remain unchanged under this flexible work arrangement.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    Download as doc, pdf, or txt
    293 views1 page

    Flexible Work Application and Agreement Form

    Uploaded by

    Suganthi Aravind
    Suganthi Chandrasekaran, a manager at ATCI, has applied for a part-time flexible work arrangement working 20 hours per week. She provides her contact information for working remotely from her home in Gurgaon, Haryana. The reason for her request is to support her daughter who has had a kidney transplant and requires treatment and support. By signing, she agrees her terms and conditions of employment remain unchanged under this flexible work arrangement.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 1

    Supporting Document to India Supplement 0047_C19

    Flexible Work Application and Agreement Form


    (To be filed in personal records of the employee)

    I. To be completed by the employee

    Name: SUGANTHI CHANDRASEKARAN


    Level: MANAGER
    SAP ID:10297379
    Entity: ATCI
    Counselor: Tushar. Kulkarni

    Select the Flexible Work Arrangement (FWA) being applied for

    Flextime
    Part-time** 
    Telecommuting/Home working

    **Please indicate the reduced number of hours to be worked per week: 20 hours/week.
    Further, for employees choosing the part time option, a separate letter would be issued by the HR
    representative to effect the revised compensation and benefit details.

    Please provide location and contact details if the employee would be working from a non
    Company location -

    Address:
    Phone number: 8826479393
    Alternate Address:001, Tower 4, South close apartments, Sector 50, Gurgaon, Haryana 112018
    Alternate phone number: 8800211007

    Reasons for application/justification


    _My daughter is a kidney transplanted kid and there is a treatment planned to support her growth.
    Considering her health condition to support her as required I am requesting for a part-time working
    option._______________________________________________________________

    The employee undertaking the Flexible Work Arrangement agrees that unless otherwise specified
    in writing, all their terms and conditions of employment remain unchanged.

    Signature:
    Date:

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