Supervisor Commitment Form: Alice Houston Women’s Leadership Program

TO THE APPLICANT: If you have more than one supervisor who would be impacted by your participation in the program, each supervisor must complete the form. If you are self-employed or do not have a supervisor, you do not need to complete this form.

TO THE APPLICANT’S SUPERVISOR: The Alice Houston Women’s Leadership Program requires a commitment not only from the individual participating in the program, but from the candidate’s employer(s) as well. Please complete this form to indicate that you, as the candidate’s full-time supervisor, support the candidate and understand the commitment.

Deadline: Friday, December 9, 2022 at 11:59 p.m.

Your name and contact information
Candidate's supervisor.
Supervisor's Name*
First Last
Supervisor's Email*
Enter Email Confirm Email
Supervisor's Title*
Supervisor's Phone*
Name of Program Candidate
Candidate's Name
First Last
Candidate's Company*
Candidate's Work Email*
Enter Email Confirm Email
Program Commitments
Please check box to confirm:
I have read and understand the Supervisor Support policy.
Supervisor Support - As a supervisor of a Alice Houston Women's Leadership participant, I understand that my employee will be out of the office attending programming on the following schedule (link to calendar). I commit to supporting their participation and allowing them to fully attend the programming schedule for their cohort.
Supervisor Commitment
My (typed) signature below indicates my commitment to and understanding of the Alice Houston Women's Leadership program requirements.
Supervisor's Electronic Signature*
The TYPED SIGNATURE below will serve as my electronic signature.
Date of Supervisor Signature*
Phone
This field is for validation purposes and should be left unchanged.

Supervisor Commitment Form: Alice Houston Women’s Leadership Program

Your name and contact information

Name of Program Candidate

Program Commitments

Supervisor Commitment

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