TELECOMMUTING AGREEMENT FORMTelecommuting Agreement • March 2nd, 2006
Contract Type FiledMarch 2nd, 2006Employee Name: Job Title & Appointment Type: Division/UDDS: Is Telecommuting a Condition of Employment? Yes No - If Yes, skip the next field (Duration) Duration: Beginning through , you are authorized to perform your job responsibilities as a telecommuter working from a remote work location, unless you move to another position at the University. This agreement and theUniversity's telecommuting policy describe the terms and conditions of this telecommuting arrangement. Work Location Address: Employee Residence? Yes No Scheduled workdays at alternative work location (include times): Monday TuesdayWednesday Thursday Friday Saturday Sunday Scheduled workdays at UW - Madison work location: (include times) Monday TuesdayWednesday Thursday Friday Saturday Sunday University Property Loaned:*If University property is loaned, send one copy to Risk Management (Form must be attached to all transactions) Quantity Equipment Description, Model and Serial Number Replacement Value
TELECOMMUTING AGREEMENT FORMTelecommuting Agreement • March 2nd, 2006
Contract Type FiledMarch 2nd, 2006Employee Name: Job Title & Appointment Type: Division/UDDS: Is Telecommuting a Condition of Employment? Yes No - If Yes, skip the next field (Duration) Duration: Beginning through , you are authorized to perform your job responsibilities as a telecommuter working from a remote work location, unless you move to another position at the University. This agreement and theUniversity's telecommuting policy describe the terms and conditions of this telecommuting arrangement. Work Location Address: Employee Residence? Yes No Scheduled workdays at alternative work location (include times): Monday TuesdayWednesday Thursday Friday Saturday Sunday Scheduled workdays at UW - Madison work location: (include times) Monday TuesdayWednesday Thursday Friday Saturday Sunday University Property Loaned:*If University property is loaned, send one copy to Risk Management (Form must be attached to all transactions) Quantity Equipment Description, Model and Serial Number ReplacementValue