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ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff0000ffffffffffffffffffffffffffffffffffff ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff0000040000002701ffff030000000000}}}{\rtlch\fcs1 \af1\afs32 \ltrch\fcs0 \fs32\insrsid4334913 \par \par Flexible Working Application form \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\outlinelevel0\adjustright\rin0\lin0\rtlgutter\itap0 \shading1250\cbpat8 \rtlch\fcs1 \ab\af1\afs24\alang1025 \ltrch\fcs0 \b\f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Part A: Flexible Working Request }{\rtlch\fcs1 \ab0\ai\af1 \ltrch\fcs0 \b0\i\insrsid4334913 (to be completed by the employee)}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par Name:\tab \tab ________________________________________ \par \par Job Title: \tab ________________________________________ \par \par Department: \tab ________________________________________ \par \par \par }\pard \ltrpar\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 (1) Type of Flexible Working Request }{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 (Please tick as many as appropriate)}{\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 :}{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \par Change in actual hours of work}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f \par }{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 Job share\tab }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f \par }\pard \ltrpar\ql \fi-3600\li3600\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin3600\rtlgutter\itap0 {\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 Change in working pattern}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \tab }{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 Specify:\tab Change in start/finish times\tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \tab \tab \tab \tab }{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 Term time\tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \tab \tab \tab \tab \tab \tab \tab \tab Seasonal\tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \par \tab \tab \tab \tab \tab \tab \tab \tab Compressed hours\tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \par \tab \tab \tab \tab \tab \tab \tab \tab Annualised hours\tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \par \tab \tab \tab \tab \tab \tab \tab \tab Other\tab \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \par \tab \tab \tab \tab \tab \tab \tab \tab \tab \par Home working\tab \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \tab Specify:\tab Full\tab \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f \par }{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \tab \tab \tab \tab \tab \tab \tab \tab Partial\tab \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs22 \ltrch\fcs0 \fs22\insrsid4334913 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard\plain \ltrpar\s3\ql \li0\ri0\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \ab\af1\afs24\alang1025 \ltrch\fcs0 \b\f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 (2) Details of Flexible Working Request }{\rtlch\fcs1 \ab0\ai\af1 \ltrch\fcs0 \b0\i\insrsid4334913 (Please give full details of proposed changes): \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 \par \par \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par \par \par \par \par \par \par }\pard \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 (3) Proposed effective date(s) }{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 (Please enter dates below)}{\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 : \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 From:\tab \tab ________________________\tab \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 Until \tab \tab ________________________ in the first instance (if applicable): \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 (4) Reason for Request }{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 (Please tick as many as appropriate)}{\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 : \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid4334913 Return from maternity leave\tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f\tab }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid4334913 Childcare arrangements\tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid4334913 Other care arrangements \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f\tab }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid4334913 Study\tab \tab \tab \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid4334913 Disability or health\tab \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f\tab }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid4334913 To pursue personal interests\tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid4334913 Change in personal circumstances \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f\tab }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Other\tab \tab \tab \tab \tab \tab }{\rtlch\fcs1 \af1\afs36 \ltrch\fcs0 \fs36\insrsid4334913 \u9633\'3f \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \tab \tab \tab \tab \tab \tab \tab }{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 Please specify: _____________________ \par \par }\pard \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par {\pntext\pard\plain\ltrpar \rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\f1\lang2057\langfe1033\langfenp1033\insrsid4334913 \hich\af1\dbch\af0\loch\f1 (5)\tab}}\pard \ltrpar\ql \fi-480\li480\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb \brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \jclisttab\tx480{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0\pndec\pnstart5\pnindent360\pnsp120\pnhang {\pntxtb (}{\pntxta )}}\faauto\ls2\adjustright\rin0\lin480\rtlgutter\itap0 {\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 Impact of proposed changes }{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 (Please consider and answer the following questions in full)}{\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 What would the potential impact of these changes be on your work / the work of your department and how might these be addressed? \par }\pard\plain \ltrpar\s17\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 \par \par \par \par \par What would the potential impact of these changes be on other members of your team and how might these be addressed? \par \par \par \par \par \par What would the potential impact of these changes be on your \'93customers\'94 (eg. students) and how might these be addressed?}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par \par \par \par \par }\pard \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 (6) Other relevant information \par \par \par \par \par \par \par }\pard\plain \ltrpar\s4\ql \fi60\li0\ri0\keepn\widctlpar\faauto\outlinelevel3\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af1\afs24\alang1025 \ltrch\fcs0 \b\f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }{\rtlch\fcs1 \ab0\af1 \ltrch\fcs0 \b0\insrsid4334913 Employee\rquote s signature:\tab ____________________\tab \tab Date: \tab \tab ____________ \par }\pard\plain \ltrpar\ql \fi60\li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\insrsid4334913 \par }\pard\plain \ltrpar\s18\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af1\afs24\alang1025 \ltrch\fcs0 \b\f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 PLEASE PASS THIS FORM TO YOUR LINE MANAGER WHO WILL THEN ARRANGE A MEETING WITH YOU TO DISCUSS YOUR APPLICATION FURTHER. YOU HAVE A RIGHT TO BE ACCOMPANIED AT THIS MEETING BY A TRADE UNION REPRESENTATIVE OR FRIEND. \par \par }\pard\plain \ltrpar\s3\ql \li0\ri0\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \shading1250\cbpat8 \rtlch\fcs1 \ab\af1\afs24\alang1025 \ltrch\fcs0 \b\f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Part B: Management Decision }{\rtlch\fcs1 \ab0\ai\af1 \ltrch\fcs0 \b0\i\insrsid4334913 (to be completed by the line manager following meeting with employee) \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par Please refer to }{\field{\*\fldinst {\rtlch\fcs1 \ab\ai\af1 \ltrch\fcs0 \b\i\insrsid4334913 HYPERLINK "http://www.bris.ac.uk/personnel/policies/flexworkmanagers.pdf" }{\rtlch\fcs1 \ab\ai\af1 \ltrch\fcs0 \b\i\insrsid13204883\charrsid4334913 {\*\datafield 00d0c9ea79f9bace118c8200aa004ba90b0200000003000000e0c9ea79f9bace118c8200aa004ba90b7c00000068007400740070003a002f002f007700770077002e0062007200690073002e00610063002e0075006b002f0070006500720073006f006e006e0065006c002f0070006f006c00690063006900650073002f00 66006c006500780077006f0072006b006d0061006e00610067006500720073002e00700064006600000000}}}{\fldrslt {\rtlch\fcs1 \ab\ai\af1 \ltrch\fcs0 \cs21\b\i\ul\cf2\insrsid4334913\charrsid4334913 Flexible Working Patterns: A Guide for Managers}{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \cs21\i\ul\cf2\insrsid4334913\charrsid4334913 }}}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 and consult your Faculty Personnel Manager/Head of Department as necessary/appropriate. \par \par Within 4 weeks of receipt of this form the Line Manager should arrange a meeting with the employee to discuss their request. The Line Manager should ensure that the employee is advised in advance of their right to be accompanied at the meeting by a trade union representative or friend. \par \par Following meeting, the line manager should consult as necessary/appropriate with the Head of Department before finalising a decision and complete and return this form to Personnel Services immediately so that they can write to the employee confirming the outcome within 2 weeks of the meeting. \par \par Date of meeting with employee\tab ______________________________________ \par Decision:\tab \tab \tab \tab 1. }{\rtlch\fcs1 \af1\afs48 \ltrch\fcs0 \fs48\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs40 \ltrch\fcs0 \fs40\insrsid4334913 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Request approved \par }\pard \ltrpar\ql \fi720\li2880\ri0\widctlpar\faauto\adjustright\rin0\lin2880\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 2. }{\rtlch\fcs1 \af1\afs48 \ltrch\fcs0 \fs48\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs40 \ltrch\fcs0 \fs40\insrsid4334913 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Request approved with amendments as follows: \par }\pard \ltrpar\ql \li1080\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin1080\rtlgutter\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Amendments: \par \par \par \par }\pard \ltrpar\ql \fi720\li2880\ri0\widctlpar\faauto\adjustright\rin0\lin2880\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 3. }{\rtlch\fcs1 \af1\afs48 \ltrch\fcs0 \fs48\insrsid4334913 \u9633\'3f}{\rtlch\fcs1 \af1\afs40 \ltrch\fcs0 \fs40\insrsid4334913 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Request declined for the following reasons: \par }\pard \ltrpar\ql \li1080\ri0\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \faauto\adjustright\rin0\lin1080\rtlgutter\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Reasons: \par \par \par \par }\pard \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par Effective dates of agreed changes : \tab \par \par }\pard \ltrpar\ql \fi720\li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 From \tab __________\tab \tab Until __________i}{\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 n the first instance (if applicable)}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \tab }{\rtlch\fcs1 \ai\af1\afs20 \ltrch\fcs0 \i\fs20\insrsid4334913 (NB changes will be considered as permanent unless specifically agreed otherwise) \par }\pard \ltrpar\ql \fi60\li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard\plain \ltrpar\s18\qc \li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af1\afs24\alang1025 \ltrch\fcs0 \b\f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \ai\af1 \ltrch\fcs0 \i\insrsid4334913 PL EASE ENSURE PERSONNEL SERVICES ARE ADVISED OF ANY SUBSEQUENT CHANGES CONCERNING THESE ARRANGEMENTS \par }\pard\plain \ltrpar\ql \fi60\li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af1\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par Line Manager\rquote s Name\tab \tab _____________________________________________ \par \par }\pard \ltrpar\ql \li1440\ri0\widctlpar\faauto\adjustright\rin0\lin1440\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Signature:\tab \tab _______________________\tab Date:\tab ____________ \par }\pard \ltrpar\ql \fi60\li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par Head of Department Name\tab _____________________________________________ \par \par }\pard \ltrpar\ql \li1440\ri0\widctlpar\faauto\adjustright\rin0\lin1440\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 Signature:\tab \tab _______________________\tab Date:\tab ____________ \par }\pard \ltrpar\ql \fi60\li0\ri0\widctlpar\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 \par }\pard\plain \ltrpar\s5\ql \li0\ri0\keepn\widctlpar\faauto\outlinelevel4\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af1\afs24\alang1025 \ltrch\fcs0 \b\f1\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid4334913 PLEASE PASS THIS FORM TO PERSONNEL SERVICES IMMEDIATELY WHO WILL THEN WRITE TO THE EMPLOYEE TO FORMALLY CONFIRM THE OUTCOME OF THIS PROCESS WITHIN 2 WEEKS OF THE MEETING AND MAKE ANY APPROPRIATE ADJUSTMENTS TO THE CONTRACT OF EMPLOYMENT \par }}