Remote Work Request Form (Enrolled PhD Students)

Enrolled PhD students in the Graduate School of Arts and Sciences are required to seek approval for any proposed remote work (i.e., employment-based activity as defined by the Local 33 contract) both from their adviser/PI and the Dean of their school. PhD students seeking permission to complete employment activities remotely must submit a request for review to the Graduate School through this form.

Important note: Such approval does not constitute approval related to student registration status: PhD students are expected to register in residence for the duration of their program. By definition, students registered in residence are required to meet their academic obligations in-person, on campus for the duration of the term in which they hold this registration status. See Registration Options for Advanced PhD Students for an overview of registration options and definitions in the Graduate School of Arts and Sciences.

Student Name (Last, First)

SID (Student ID: this is a 9-digit number that begins with 9)

@yale Email Address (note all communication will be sent to this address)

Your country or countries of citizenship (i.e., of which you are a passport holder)

Degree program

Department/program

Combined department/program (if applicable)

PI/Adviser name

PI/Adviser @yale email address

Location(s) in which proposed remote work will take place (list all that apply)

This answer should include any international or domestic location, including any location in a state outside of Connecticut.

Duration of stay in each location (list dates of stay for each)

If you are not a citizen of the destination country (site of remote employment), how will you manage visa requirements?

Is your funding supplied by grants (in whole or in part)?

Yes

What is the source of your grant funding?

NIH

NSF

DOD

NASA

Other

If you selected "Other", describe here your grant funding source

List the IRES or Workday Award Number of your grant funding source

Describe in detail the employment activities you propose to undertake while in the remote location(s)

List here any additional information you believe to be relevant to the evaluation of this request

Upload written documentation of your adviser's approval of this proposed remote work arrangement

One file only.
100 MB limit.
Allowed types: pdf.