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Flexible Work Request
FairWork
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Your details
Your name
Role title
Email
Phone
Employer / manager
Employer name
Manager name (optional)
Eligibility
I am a regular casual employee
Months of continuous service
Section 65 requires at least 12 months.
Ground(s) on which you qualify (tick all that apply)
Parent/carer of a child of school age or younger
Carer (Carer Recognition Act 2010)
I have a disability
I am 55 or older
I am pregnant
Experiencing family / domestic violence
Supporting a family / household member experiencing family violence
Optional context (only if you want to share)
The change you're asking for
Describe the change
Why you need it
Proposed start date
Trial period (months, optional)
Offering a trial often lands better than an open-ended change.
How you'll manage any impact on the team
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