APPENDIX A

ALTERNATE WORKSITE WORK AGREEMENT

The following constitutes an agreement between:

____________________________________ and _________________________________________
Employee's Name                           Supervisor's Name

of (Service, Office, Division, Branch, Section, etc.) ______________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________
of the U.S. Office of Personnel Management to participate in the alternative worksite (telecommuting) program.


Tour of Duty
All work schedule flexibilities currently permitted may be continued in a telecommuting arrangement.  Please identity the hours a
telecommuter will work each day as well the location (alternative vs office).

FIRST WEEK:                                SECOND WEEK:

Monday_____________________                Monday___________________

Tuesday____________________                Tuesday__________________

Wednesday__________________                Wednesday________________

Thursday___________________                Thursday_________________

Friday_____________________                Friday___________________

Assignments and Communication

This should include work assignments, agreements on checking voice mail and email or contacting the supervisor as well as the requirement for employees to come into the office as needed. If additional space is required, attach another sheet to the agreement.

______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________

Length of Agreement

The employee will begin telecommuting on: ____________________ (begin date).

This telecommuting schedule will be (check one) _______ indefinite _______ temporary; until ____________ (end date).

Duty Station

The address of the employee's official duty station is _____________________________________________________

The address and phone of the employee's alternate worksite is ______________________________________________


Check one

____residence        ____telecenter