{{company_name}}
{{company_address}}
Phone: {{phone}} | Email: {{email}} | Web: {{website}}
| Item | Yes | No | Notes |
|---|---|---|---|
| Quiet, dedicated workspace | ☐ | ☐ | |
| Reliable internet (>20 Mbps) | ☐ | ☐ | |
| Ergonomic chair and desk | ☐ | ☐ | |
| Laptop and peripherals | ☐ | ☐ | |
| Privacy for confidential calls | ☐ | ☐ |
| Signature | Date | |
|---|---|---|
| Employee: {{employee_name}} | ____________________ | {{date}} |
| Manager: {{manager_name}} | ____________________ | {{date}} |
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