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.

  • Name of Program Candidate

  • Program Commitments

  • Supervisor Commitment

    My (typed) signature below indicates my commitment to and understanding of the Alice Houston Women's Leadership program requirements.
  • The TYPED SIGNATURE below will serve as my electronic signature.
  • This field is for validation purposes and should be left unchanged.