Flexible Work Request Template

[Your Full Name] [Your Address] Phone: [Your Phone Number] Email: [Your Email] [Date] [Manager's Name] [Manager's Title] [Company Name] [Company Address] Dear [Manager's Name], RE: Request for Flexible Working Arrangements — Section 65, Fair Work Act 2009 I am writing to formally request a change to my working arrangements under section 65 of the Fair Work Act 2009 (Cth) and the National Employment Standards. I have been employed with [Company Name] as a [Your Position/Title] since [Your Employment Start Date], which is more than 12 months of continuous service. Eligibility I am eligible to make this request because: [Eligibility Reason]. Arrangement Requested I am requesting the following change to my working arrangements: [Flexible Arrangement Requested] I propose that this arrangement commence from [Proposed Start Date for Arrangement]. I believe this arrangement can work effectively and I am happy to discuss how my responsibilities can continue to be met. I am open to a trial period to demonstrate the viability of this arrangement. Under the Fair Work Act, you are required to provide a written response to this request within 21 days. A request may only be refused on reasonable business grounds, and any refusal must be in writing with detailed reasons. I look forward to discussing this request with you. Yours sincerely, [Your Full Name]