Form

Request flexible working: application form template

You can use this form to make an application to work flexibly under the right provided in law to eligible employees.

Documents

Details

Applications to work flexibly must include:

  • the date
  • a statement that this is a statutory request
  • details of how you want to work flexibly and when you want to start
  • an explanation of how you think flexible working might affect the business and how this could be dealt with, for example if you’re not at work on certain days
  • a statement saying if and when you’ve made a previous application

You can write an email or letter to your employer or use one of the form templates above.

You should note that it may take up to 3 months to consider a request - or longer if you agree a longer decision period with your employer.

Before you start

Read the guidance on flexible working, and check that you are eligible to make a request.

Published 4 July 2014