Travel and Remote Work Requests

Which form are you looking to complete*

Travel Authorization Request FormRemote Work Request & Agreement Form
Travel Authorization Request Form
This form must be completed and approved prior to any work-related travel, including in-state and out-of-state trips.
Describe the purpose of the travel including how it relates to your duties or department objectives:*
Departure Date*

MonthDayYear
Date
Return Date*

MonthDayYear
Date
Destination (City, State)*
Employee Name*
Employee Signature*
Date*

MonthDayYear
Date
Department Head Name*
Remote Work Request & Agreement Form
Employee Information
Full Name*
Job Title*
Department*
Remote Work Type
Work to be completed during this time period will be:*

Ongoing (Regular Schedule)Situational (Specific Dates Only)
Describe the specific work that will be completed while working remotely*
Proposed Remote Work Schedule
Requested Remote Days/Times*
Remote Work Expectations & Employee Acknowledgment
By checking the boxes below, you are agreeing to each of the following:*

I will be available and responsive during my standard work hours (or approved alternate hours).I will maintain all performance expectations and deadlines while working remotely.I will comply with all Roane County Government security policies and data protection protocols.I will only use county-issued equipment for remote work and will not store confidential data on personal devices.I will ensure my remote work environment is safe, professional, and conducive to productivity.
Additional Requirements for Ongoing Remote Work

(Complete this section only if "Ongoing" is selected above)
Regular Remote Workdays (e.g., M/W/F)*
Typical Hours on Remote Days*
Work Assignment & Communication Plan*
Check-in Frequency with Supervisor*

DailyWeeklyBi-WeeklyOther
If Other, detail the frequency*
Employee Signature*
Date*

MonthDayYear
Date
Please note: Submitting this form does not guarantee approval. The information provided will be forwarded to your direct supervisor for review. You will be contacted once a decision has been made regarding approval or denial.
Should be Empty:

Travel Authorization Request Form

Remote Work Request & Agreement Form

Employee Information

Remote Work Type

Proposed Remote Work Schedule

Remote Work Expectations & Employee Acknowledgment

Additional Requirements for Ongoing Remote Work