Sample Telework Assignment

Here is a Sample Telecommuter Assignment form developed by CommuterChallenge.org, an initiative of EnterpriseSeattle.org, that has been fostering public/private partnerships to find solutions to its region’s transportation issues for over 18 years.

A Teleworker’s Assignment form is completed to define the specifics of teleworking such as frequency, type of work to be completed, the number of times the employee should communicate with the office, etc.  The Assignment is completed by the teleworker and the telemanager.

Sample
Teleworker Assignment

Teleworking, or working from another location such as home or an office close to home, is an assignment that the company may choose to make available to some employees when a mutually beneficial situation exists.

Teleworking is not an employee benefit, but rather an alternative method of meeting the needs of the company.  Employees do not have a “right” to telework.  The arrangement can be terminated by either the employee or the company at any time.

Conditions for teleworking agreed upon by the teleworker and his/her supervisor:

1.    The employee agrees to work at the following location: _______________________________________________________________________

2.    The employee will telework ___________days per week.

3.    The employee’s work hours will be from _____a.m. to ______p.m.

4.    The following are the assignments to be worked on by the employee at the remote location, with expected delivery dates:
________________________________________________________________________________________________________________________________________________
________________________________________________________________________

5.    The following equipment will be used by the employee at the remote location:
________________________________________________________________________________________________________________________________________________

6.    The employee agrees to call the central office to get his/her messages at least ________ times per day.

7.    The employee agrees to get all supplies needed for teleworking from the company office.  Reimbursement for out-of-pocket expenses for supplies will need prior supervisory approval.

8.    Additional conditions agreed upon by the telemanager and teleworker are as follows:
________________________________________________________________________________________________________________________________________________________________________________________________________________________

I have reviewed the teleworker’s assignment with _________________________prior to his/her participation in the company’s teleworking program.

________________________________________________________________________
Date                                                                                Supervisor Name

The above material has been discussed with me.

________________________________________________________________________
Date                                                                                Employee Name

–End–

Disclaimer: This document is offered as a conceptual sample. Your own document should reflect your company’s policies as well as local, state, and federal regulations. Be sure to consult an attorney familiar with employment law before using any such document.

Sample Telework / Telecommuting Policy: This sets forth a company’s overall policies toward telework.

Sample Telework / Telecommuting Agreement: This documents the understanding between the company and the teleworker or telecommuter.

If you’re looking for samples of documents that employees would use to suggest, request, or justify telecommuting, visit our Individuals: How to Pitch Your Boss on Telework pages.

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In The News

Teleworkers keep government open during snowstorms, Baltimore Sun, March 14, 2014

It’s Unclearly Defined, but Telecommuting is Fast on the Rise, New York Times, March 7, 2014

Telework Yields $32 Million in Snow Day Savings, Forbes, February 27, 2014

Lone Eagle Cities: Where the Most People Work from Home, NextGov, March 3, 2014

Madison firms not about to ban telecommuting, Capital Times, February 25, 2014

How To Build and Sustain a Remote Workforce, Fast Company, February 21, 2014

Accountability, The Key to Federal Telework, Federal Times OpEd by Kate Lister, February 6, 2014

Florida Among the Top 10 States for Telecommuting Jobs, Jacksonville Business Journal, February 10, 2014

Federal Telework Surge Could Save $14 Billion Annually , Wired Workplace, January 25, 2014

Measuring the Impact of Workplace Flexibility, 1 Million for Flexibility, January 24, 2014

FEDTalk, Federal News Radio interviews Kate Lister on the Office of Personnel Management’s latest Status of Telework—Report to Congress, January 24, 2014

Report Says Telework Could Save Government $14 Billion a Year, Federal Computer Week, January 24, 2014

Federal Telework Surge Could Save $14 Billion Annually, NextGov, January 24, 2014

Telestorming: When weather and disasters forces people to work from home, Deseret News, January 10, 2014

Why Telework When You Can Take a Snow Day?, Nextgov.com, January 4, 2014

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