Examples of Alternate Supervisor in a sentence
Supervised Practice, and I agree to supervise and evaluate this Applicant in accordance with the responsibilities of the Alternate Supervisor.
Practicum Supervisor Contact Details Primary Supervisor Name: Mailing Address: Site Phone Number: Fax: E-mail: Alternate Practicum Supervisor Contact Details Alternate Supervisor Name: Mailing Address: Site Phone Number: Fax: E-mail: Practicum Supervisor Abbreviated Curriculum Vitae Supervisor: Please complete the abbreviated curriculum vitae on the last page of this form.
Student Information Faculty Sponsor Information Name Name Street Street City State Zip City State Zip Phone Phone E mail Address E mail Address Signature (REQUIRED) Date Signature (REQUIRED) Date Field Supervisor Information Alternate Supervisor Information Name Name Street Street City State Zip City State Zip Phone Phone E mail Address E mail Address Signature (REQUIRED) Date Signature (REQUIRED Date The typed internship agreement must be attached to this form.
Name of the worksite: Title of Work Based Project/ Worksite Address: Phone: Name and Title of On-Site Supervisor: Phone: Name and Title of Alternate Supervisor: Phone: Ratio of Participants to Supervisor: to Participant Job Title Number of Slots Slot(s) shall commence on and continue until for a period of weeks.
Worksite Supervisor Signature Date Alternate Supervisor Signature (if applicable) Date WIOA Representative Signature Date IMPORTANT! This document contains important information about your rights, responsibilities and/or benefits.
Trainee Signature Date Worksite Supervisor Signature Date WIOA Representative Signature Date Alternate Supervisor Signature Date If a Trainee Work Plan is being modified for any other reason other than changing Worksites, complete the modification section below.
Trainee Information Trainee Name: Trainee Phone #: Participant ID: Program: Emergency Contact: Emergency Contact Phone #: Worksite Information Worksite: Worksite Address: Worksite Phone #: Days/ Hours of Operation: Supervisor: Phone #: Alternate Supervisor: Phone #: General Training Information Job Title: Hourly Wage: Maximum Hours: Work Schedule: Work Location: Estimated Start Date: Estimated End Date: Duties and Responsibilities 1.
I confirm that supervision of this Applicant began on, or will begin on, (Date): Supervision will take place at (specify employment setting(s)): Signature of Alternate Supervisor: Signed on (Date): Name of Primary Supervisor: APPLICANT’S ACKNOWLEDGMENT (must be completed by the Applicant): I acknowledge receipt of a copy of this agreement and agree to comply with the requirements stated in the College's Registration Guidelines during my period of authorized supervised practice.
SUBMITTED TO THE COLLEGE OF PSYCHOLOGISTS OF ONTARIO Name of Supervised Practice Applicant: Name of Alternate Supervisor: SUPERVISOR’S AGREEMENT (must be completed by the Supervisor): Check boxes to agree I agree to act as Alternate Supervisor for this Applicant during the period authorized by the College.
Trainee Signature: WIOA Work Experience Worksite Orientation Worksite: Worksite Address: Phone #: Worksite Supervisor: Phone #: Email: Alternate Supervisor: Phone #: Email: Acknowledgement of Receipt This is to certify that I have received, read, and understand the rules, regulations, and instructions contained in this orientation packet.