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Flexible Work Plan Request Form

Ithaca College will actively encourage Flexible Work Plans (FWPs) where it is reasonable and practical to do so and where the College’s goals and operational needs will be met while improving employee satisfaction. Because services within each department vary, approval is on a case-by-case basis, the number and type of flexible schedules may vary widely depending on the needs of those being served.

Employee Information

Name*
Supervisor Name*

Please choose your Human Resources Business Partner from the drop down menu below. 

  • Michelle Hammond
  • Julie Tinkham (Schools - Business, Communications, HSHP, H&S, Music)
  • Jenn Brown (Finance and Administration)
  • Kimberly Lieb (Student Affairs and Campus Life)
  • Katie Sack (Marketing and Enrollment Strategy, Philanthropy and Engagement, and IT)

Work Plan Request

Work Plan Type*
Work Schedule Start Date*

Describe the proposed schedule by listing start and end times for both on and off-site below. Please include date and times, along with a lunch period if applicable. Example: 

Monday: On Campus or Off Campus

Daily Schedule: 8:30am - 5:00pm, Lunchtime from 12:00pm - 1:00pm

Please note: flexible work plans require the same amount of hours worked per week as described by the position. 

*Hybrid Work Schedule consist of schedules that have split working days (day is split with some time on campus and some time off campus).

Sunday*
Monday*
Tuesday*
Wednesday*
Thursday*
Friday*
Saturday*

Work Plan Rationale

The nature of work and/or the needs of Ithaca College may preclude a Flexible Work Plan. Flexibility is appropriate where both the needs of IC and the needs of the employee are met. However, a FWP is not a right of employment and IC reserves the right to alter, amend, or withdraw this policy at any time with reasonable notice.

Telecommuting

As noted in the Telecommuting Policy, the nature of work and/or the needs of Ithaca College may preclude a telecommuting arrangement. Telecommuting is appropriate where both the needs of the College and the needs of the employee are met. However, telecommuting is not a right of employment and the College reserves the right to alter, amend or withdraw telecommuting at any time with reasonable notice. Please note that telecommuting is not intended to permit employees to have time to work at other jobs or to run their own businesses. Failure to fulfill normal work requirements due to other employment may be cause for disciplinary action or termination of employment. The employee must be accessible during telecommuting hours.

Where will the work be completed? *
Do you have reliable internet at your remote location? *

Agreement

This form, or any other written or oral information contrary to it, does not create or imply an employment contract, contractual rights or any entitlements between the employee and the College. The College reserves the right to amend this document at any time.

By signing this agreement, the employee hereby agrees to abide by all College policies, practices, etc. as they normally would on-campus in addition to the security of any College data accessed remotely, data accessed electronically, or hard-copy resources taken from the campus. Additionally, the employee agrees to comply with the provisions set forth in this plan.

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Today's Date

Supervisor Approval

This form is used to approve or deny a Flexible Work Plan (FWP). Supervisors and Employees should work in conjunction to create a plan that work for all needs. FWPs may be changed, suspended, or cancelled at any time. FWPs are not a benefit, entitlement, or accommodation; they must make business sense. 

This FWP is
Approved Start Date:
Review Date:
FWPs should be periodically reviewed. It is recommended that supervisor schedule the first review within 2 months of the FWP start date.

Please choose from the drop down, your Division Leader or Dean. Once the FWP is submitted by you (the supervisor), it will be routed to the Division Leader or Dean chosen below. You must also select the correct email address associated with the Division Leader or Dean.   

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Today's Date

Division Leader or Dean Approval

This FWP is
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HR Review

HR Reviewer