HR - Flexible Working Application Form This form is used to make a flexible working request. This request can include any change to existing working arrangements such as: • Remote working (e.g., working from home) • Flexible hours (e.g., start and finish times) • Part-time work • Compressed hours (e.g., working full-time hours over fewer days) • Job sharing Name(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Last Parish or Department(Required)Please select or typeAbbots Langley (Abbots Langley)Abbots Langley (Chipperfield)ActonActon EastActon WestAgency for EvangelisationAllen Hall SeminaryArchbishop's HouseArchwayAshfordBaldockBarnetBayswaterBerkhamstedBethnal GreenBishop's StortfordBishop's Stortford (Much Hadham)Bishop's Stortford (Sawbridgeworth)BorehamwoodBorehamwood NorthBowBow CommonBrentfordBrook GreenBunhill RowBuntingfordBurnt OakBushey and OxheyCamden TownCaritasCaritas - Bakhita HouseCaritas - Deaf ServiceCaritas - St Joseph'sCaritas Seeds HubCarpenders Park and South OxheyCathedralChanceryChelsea 1Chelsea 2CheshuntChiswickChorleywoodClaptonClapton ParkClerkenwellCockfostersCommercial RoadCommunicationsCopenhagen StreetCovent GardenCranfordCricklewoodCroxley GreenCuffleyDollis HillDPOEaling AbbeyEastcoteEdgwareEdmontonEducationEly PlaceEnfieldFarm StreetFelthamFinanceFinchley Church EndFinchley EastFinchley NorthFrench ChurchFulham 1Fulham 2 Stephendale RoadFulham RoadFundraisingGarstonGerman ChurchGolders GreenGrahame ParkGreenfordGrove ParkGunnersburyHackneyHammersmithHampsteadHampton HillHampton-on-ThamesHanwellHarefieldHarpendenHarrow NorthHarrow RoadHarrow South (Harrow South and Northolt)Harrow-on-the-HillHatfieldHatfield SouthHaverstock HillHayesHeadstone LaneHeathrow AirportHemel Hempstead East (Hemel Hempstead East)Hemel Hempstead East (Hemel Hempstead North)Hemel West (Hemel Hempstead West)Hemel West (Hemel Hempstead)HendonHendon WestHertfordHestonHighburyHighgateHillingdonHitchinHoddesdonHollowayHomertonHounslowHoxtonHRICTInterfaithIsleworthIslingtonItalian ChurchJustice & PeaceKensal New TownKensal RiseKensington 1Kensington 2Kentish TownKentonKilburnKilburn WestKingsbury GreenKingslandKnebworthLebanese ChurchLetchworth Garden CityLimehouseLincoln's Inn FieldsLithuanian ChurchLondon ColneyManor HouseMaryleboneMile EndMill EndMill HillMillwallMoorfieldsMuswell HillNeasdenNew BarnetNew SouthgateNorthfieldsNortholt (Harrow South and Northolt)NorthwoodNotting HillOgle StreetOld Hall GreenOratoryOsterleyPaddingtonPalmers GreenParish Support TeamParsons GreenPerivalePilgrimagesPimlicoPinnerPolish Church 1 (Islington)Polish Church 2 (Hammersmith)Polish Church 3 (Ealing)Ponders EndPoplarPotters BarProperty ServicesQueenswayRadlettRedbourn (Flamstead & Markyate)RickmansworthRoystonRuislipRuislip SouthSafeguardingSchools FinanceShenleyShepherds BushSheppertonSoho SquareSomers TownSouthallSpanish PlaceSt AlbansSt Albans SouthSt Charles SquareSt John's WoodSt Margarets-on-ThamesStaines-upon-ThamesStamford HillStanmoreStanwellStevenage BedwellStevenage ShephallStevenage TransfigurationStoke NewingtonStonebridgeStroud GreenSudburySunbury-on-ThamesSwiss CottageTeddingtonTollington ParkTottenhamTower HillTribunalTringTwickenhamUkrainian CathedralUnderwood RoadUniversity ChaplaincyUxbridgeWaltham CrossWappingWareWarwick StreetWatfordWatford NorthWealdstoneWelwyn Garden CityWelwyn Garden City DigswellWelwyn Garden City EastWembley 1Wembley 2Wembley 3West Drayton and YiewsleyWest GreenWestminster Youth MinistryWheathampsteadWhetstoneWhite CityWhittonWillesdenWillesden GreenWood GreenYeadingJob Title(Required)Your Email(Required) Line Manager Name(Required)Line manager email address(Required) What changes are you requesting to your working hours or pattern of work?(Required)Do these changes require remote working?(Required) Yes No On what date would you like your requested flexible working to start?(Required) DD slash MM slash YYYY Is your application in relation to the Equality Act 2010, for example, as a reasonable adjustment for a disability?(Required) Yes No Please give detailsWhat would be your proposed working schedule?Monday(Required) Office Remote Not a work day Time(Required)Tuesday(Required) Office Remote Not a work day Time(Required)Wednesday(Required) Office Remote Not a work day Time(Required)Thursday(Required) Office Remote Not a work day Time(Required)Friday(Required) Office Remote Not a work day Time(Required)Signature(Required)EmailThis field is for validation purposes and should be left unchanged.
