USGS FLEXIBLE WORK SCHEDULE AGREEMENT 1) Employee Name: ________________________________________________________
2) Position title/Series/Grade: ________________________________________________________
3) I elect to work the following flexible work schedule:
4) My flexible arrival time band is from ______ a.m. to ______ a.m.
My flexible departure time band is from ______ p.m. to ______ p.m.
My flexible time band for lunch is from ______ a.m. to ______ p.m.
Core hours will be: __________________________________________ (times of day) on the following days of the week: ____________________________________________________
Maxiflex schedules only: My AWS day(s) off will be: ____________________________________________________________________
5) I have read, understand and agree to all provisions of the USGS AWS policy that are applicable to the schedule I have requested.
I understand that I may not arrive earlier than the beginning of the arrival time band nor depart later than the end of the departure time band.
I understand that with supervisory approval, I may extend my lunch period within the flexible time band for lunch and must either account for that time by using leave or make up the time during the same day (Gliding) or pay period (Maxiflex).
I understand that I am required to be present at work on each of the ten workdays (or established workdays under Maxiflex) of the pay period and during core time as indicated above, or I must account for my absence with the appropriate leave.
I understand that I may be requested to arrive at an alternative or a specific time on occasion when necessary to provide office coverage, attend meetings, training, or conferences and that when requested, I must comply.
I understand that under Maxiflex, I must inform my immediate supervisor in writing of my planned work schedule by the beginning of each pay period.
6) Employee Signature: ___________________________________ Date: ____________
-The following section is to be completed by the supervisor- 7a) ____Approved _____ Not Approved
7b) Reason for Disapproval: ________________________________________________________________________
8) This agreement will become effective Pay Period No. _________
9) Supervisor Signature: ___________________________ Date: _______________