Work From Home Form: Dalubhasaan NG Lunsod NG San Pablo

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CITY GOVERNMENT OF SAN PABLO

DALUBHASAAN NG LUNSOD NG SAN PABLO


CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Member, Association of Local Colleges and Universities
Excellence • Leadership • Service Member, Local Colleges and Universities Athletic Association, Inc.

WORK FROM HOME FORM


Employee Name: ___________________________
Division/Office: ____________________________

To the CHRMO:

In compliance with the Guidelines for Alternative Work Arrangements and Support Mechanisms for Personnel in the Dalubhasaan ng Lunsod ng San Pablo
for the duration of State of Public Health Emergency, I hereby submit my Worksheet Plan for June 1-30, 2020.

Alternative Work Arrangement


Date Pre-existing Time and Period Target
Health Deliverables Remarks
Condition for the
and/or Day/Week
Disease Monday Tuesday Wednesday Thursday Friday

Prepared by: Noted by:

________________________ ___________________________

(Signature over printed name) (Immediate Head/Supervisor)

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