# Remote Work Request Template

This Remote Work Request Template allows you to collect remote work requests or details from employees in a clear and organized way.

The template includes common remote work form fields such as work location, dates, availability, and can be easily customized to match your company policy.

This free remote work form template helps teams manage remote work requests consistently and keep everyone aligned.

### First Name

* Required

### Last Name

* Required

### Job Title

* Required

### Email

* Required

### Start Date

* Required

### On which days would you like to work from home?

* Required

On which days would you like to work from home?

- Monday
- Tuesday
- Wednesday
- Thursday
- Friday

### What additional equipment do you need at home?

What additional equipment do you need at home?

- Chair
- Monitor
- Desk
- Keyboard
- Mouse
- Charging station
- Other

### Is there anything else we can do to make your remote working experience better?

### How productive is your average working day at home?

* Required

How productive is your average working day at home?

0
1
2
3
4
5
6
7
8
9
10

Not productive at all  Very productive

### Please sign your request

* Required

Signature

Submit

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