FWA Guidelines

FWA Proposal Form

The FWA Proposal Form is at the heart of MacKay’s Proposal and Review Process. It is to be completed for new participant arrangements and schedule modifications made to those arrangements. However, if your request is being made because of your own medical condition or that of a family member, consult with your Human Resources Director or Office Managing or Personnel Partner. This form is a tool to help you think through ways to do your job more flexibly and efficiently.

CLICK HERE to complete the Microsoft Word version of the form. This version can be saved and submitted later as an e-mail attachment. PLEASE USE THIS MICROSOFT WORD VERSION TO COMPLETE AND SUBMIT YOUR FORMAL PROPOSAL.

The FWA Proposal Form below is a visual worksheet only and cannot be saved or submitted electronically. Click on "Tip" after questions 1-7 for help in developing answers for those questions. Click Here for a printer-friendly set of tips for both managers and team members on how to best use the form.

Name ______________________________________________
Job Title ______________________________________________
Office ______________________________________________
Date Request Submitted to Manager ______________
Manager ______________________________________________

FWA Requested

__ FlexTime __ Part-Time __ Compressed Workweek
__ Job Sharing __ Telecommuting
__ Combination/Other (Please Specify) _____________________________________

Describe your current schedule and your proposed schedule:

Days/Hours	Current Schedule		Proposed FWA
	On-Site	Off-Site	On-Site	Off-Site
Sunday	______	______	______	______
Monday	______	______	______	______
Tuesday	______	______	______	______
Wednesday	______	______	______	______
Thursday	______	______	______	______
Friday	______	______	______	______
Saturday	______	______	______	______
Total Hours	______	______	______	______

1. How might this proposed arrangement allow you to maintain or improve your individual
     performance? Tip

__________________________________________________________________________

2. How might this proposed arrangement add value to MacKay's work? Tip

__________________________________________________________________________

3. What challenges could the proposed arrangement raise with your a) manager b) team or
     coworkers c) internal customers and d) external customers? Tip

__________________________________________________________________________

4. What solution(s) would you propose to overcome each of the challenges raised in
     question 3? Tip

__________________________________________________________________________

5. What deliverables and measurements (qualitative and quantitative) do you propose
     that you and your manager use to assess your performance? Tip

__________________________________________________________________________

6. What review process do you propose that you and your manager use to
     constructively monitor and improve your FWA? Tip

__________________________________________________________________________

7. What would be one or more warning signs that this arrangement isn't working? Tip

__________________________________________________________________________

8. Describe any additional equipment/expense that the FWA might require
     (if applicable).

__________________________________________________________________________

9. Detail any short or long-term cost savings that might result from your new FWA to
     offset any expenses mentioned in question 8.

__________________________________________________________________________

Manager Review

Proposed FWA is: ___ Approved ___ Declined ___ Modify and Resubmit

Effective date of FWA:  Beginning: _______________

Ending: ________________ (If option is time limited)

Reassessment date: ________________

(All FWAs will be reviewed after 90 days and on a periodic basis.)

Team Member: Please forward a copy of this form to your Human Resources Director once a decision has been made.