Official form guide
This form is a template for employees to request flexible working arrangements from their employer. It should be used when an employee needs to change their working hours, location, or pattern to better balance work and personal commitments.
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Form Overview
This form is a template for employees to request flexible working arrangements from their employer. It should be used when an employee needs to change their working hours, location, or pattern to better balance work and personal commitments.
Plain English
If you need to change how or when you work, this form helps you make that request to your employer in a structured way. It's not a guarantee your request will be approved, but it starts the conversation and ensures your employer considers it properly.
Submission Date
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While there's no strict deadline for submitting this form, Australian workplace laws require employers to respond within 21 days of receiving a request, so submit well in advance of when you need the changes to begin.
Field map
Applicant
1 items
Full name (and representative, if any), postal address, email, and phone number of the person or organisation lodging the application.
Respondent
1 items
The exact legal name and ABN of the employer or other party the application is made against.
The Matter
2 items
Identify the kind of matter — for example, unfair dismissal, general protections, or an agreement application.
A clear description of what happened, relevant dates, and the outcome you are seeking.
Dates
1 items
Relevant dates such as the date of dismissal or the date the issue arose — these determine whether you are within time.
Supporting
1 items
Any documents that support your application, such as letters, contracts, or notices.
Declaration
1 items
Sign and date the form. Applications may also require a fee or an application for a fee waiver.
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Fillable formOpen in Editor->This template is current as of recent Fair Work Ombudsman guidelines, but workplace policies may have additional requirements specific to your industry or employer.
Quick Facts
Many employees don't realize they need to explain how their request benefits the business
Some people confuse this form with requesting leave or other workplace changes
Employees often don't know they can request a review if their request is denied
Some workers assume all flexible work requests must be approved
People may not understand the difference between informal requests and formal submissions
Many don't realize they can request changes to trial arrangements
Some employees are unaware of their rights to request flexible work arrangements
People often don't know how to respond if their request is denied
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