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Flexible Work or Workplace Accommodation Application

Pine Manor College requires that all PMC employees who seek to work from home (WFH), regardless of how many days per week that may be, are required to complete the application below to ensure transparency and equity in the WFH approval process.

Please complete this form and submit to your supervisor for approval, and then to Shelley Dropkin, Director of Human Resources. 

Flexible Work or Workplace Accommodation Application Form

Please review the application with your supervisor, then submit to Shelley Dropkin, Director of Human Resources. Additional information may be requested, whereupon your application will be reviewed.  You will subsequently be informed of the status of your application.

For the purposes of this application, the following definitions of Workplace Accommodation and Flexible Work Agreement are as follows:

  • Workplace Accommodation – Under the ADA (Americans with Disabilities Act) and in response to COVID-19, a reasonable workplace accommodation is any change to the job or work environment that allows a person with a disability who is qualified for the job to perform the essential functions of that job and enjoy equal employment opportunity.
    • To receive a reasonable workplace accommodation, the individual must have an “actual” or “record of” a disability.
    • There must be some connection between the impairment and the specific need for the accommodation.
    • COVID-19 alone is not considered a disability.
    • Caregivers of individuals with disabilities are not entitled to workplace accommodation under Federal ADA, but may be entitled to leave under FMLA (Family Medical Leave Act) or FFCRA (Family First Coronavirus Response Act) – https://www.dol.gov/agencies/whd/pandemic/ffcra-employee-paid-leave
  • Flexible Work Agreement – This is a two-way conversation between an employee and their supervisor.
    • Consideration is given to the needs of the employee which must be in considered balance with the requirements of the position and the needs of the College.
    • This agreement can include schooling and child care issues.

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