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State of California Environmental Protection Agency Air Resources Board ASD/HRB 191 (REV 12/10)ALTERNATE WORK WEEK SCHEDULE (9/8/80 AND 4/10/40) REQUEST AND AGREEMENT Name:Division:Position #:AWLS
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How to fill out alternate work week schedule:

01
Begin by obtaining a blank copy of the alternate work week schedule form from your human resources department or employer.
02
Fill in your personal information, such as your full name, employee ID number, and department.
03
Indicate the desired period for the alternate work week schedule. This typically includes the start and end dates for the schedule.
04
Specify the regular work hours for each day of the week. This will outline the standard schedule for the alternate work week.
05
Outline the proposed alternate work week schedule by indicating which days you will be working, any changes to the regular work hours, and any days off you will have during the alternate schedule.
06
Include any additional information or comments that may be required or helpful for your employer to consider when reviewing your alternate work week schedule request.
07
Review the completed form to ensure all the necessary information is provided and accurately filled out.
08
Sign and date the alternate work week schedule form to indicate your consent and submission.

Who needs alternate work week schedule:

01
Employees who desire a flexible work schedule to accommodate personal commitments or preferences may benefit from an alternate work week schedule.
02
Individuals who face challenges with the traditional Monday to Friday, 9-to-5 work schedule and need to adjust their working hours for better work-life balance may find the alternate work week schedule useful.
03
Companies that operate in sectors with extended or nontraditional working hours, such as hospitality, healthcare, transportation, or customer service, often implement alternate work week schedules to ensure adequate coverage and employee availability.
04
Parents or caregivers who require flexibility in their work schedule to accommodate childcare responsibilities may find the alternate work week schedule beneficial.
05
Employees who want to reduce commuting time or avoid peak traffic hours may choose to adopt an alternate work week schedule to adjust their working hours accordingly.
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