My Flexible Working Request Form - Our Tesco


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My Flexible Working Request Form Name:

Employee Number: Current Work Pattern Place of work:

Days and hours currently worked: M

T

W

T

F

S

S

W

T

F

S

S

Requested Work Pattern Place of work:

Days and hours currently worked: M

T

I would like to start working this new pattern on

Reason for my statutory request:

My Flexible Working Request Form I believe this will benefit Tesco because: (examples might include: increased business coverage, more focus on key priorities, level of commitment to Tesco, retention of skills and knowledge etc.)

My new ways of working may impact my colleagues and key contacts by: (Consider who will do your job when you are not working, how much support you give to the team, how much of your work you are able to delegate, additional pressure on team, the impact on those who manage you, knowledge and skills you have which others don’t)

I’d suggest these solutions:

Signed

Date