Request for Flexible Hours

Employee Name: 

Department: 

I request the following Flexible Hours Schedule:

Schedule 4 days per week

Flex Day    Morning or Afternoon Hours

I agree with the following:

1. Once approved, I cannot change or make exception to this schedule without manager approval.
2. Manager may require variations in my schedule based on needs of the department and company.
3. I understand for situations of my absence, regardless of reason, for two or more days, within a workweek, the standard schedule is used during that specific workweek, with no Flex Day.
4. This schedule is to be my regular schedule, and I will adhere to it unless and until there has been a change or exception made to it, as set forth above or pursuant to the Sanofi US Flexible Work Policy.
5. Unless I am working standard business hours, I understand that some weeks I may be required to work on a standard business schedule to ensure my department has sufficient business coverage and that business needs are met.


_____________________________________________________________________
Flextime Worker’s Name (please print)                                    Signature and Date

I have reviewed this agreement with this employee and witnessed the employee's signature.


_____________________________________________________________________
Manager's Name (please print)                                                Signature and Date