UTSA Head Start
Summer Institute
UTSA Head Start Summer Institute 2010
Supervisor’s Approval Form
I, _____________________________________, _____________________________________________,
Supervisor’s Name
Supervisor’s Title & Name of Head Start Center
approve the attendance of ______________________________________________________
Applicant’s Name
at one or both of the three-week UTSA Head Start Summer Institute sessions offered at The University of
Texas at San Antonio, San Antonio, Texas. Please mark the session(s) the applicant will attend:
_____ June 7 – June 25, 2010
_____ June 28 – July 16, 2010
I understand that registration, tuition fees and required textbooks will be paid for by the UTSA Head Start
Summer Institute and that the Institute will provide lodging for participants at the UTSA University Oaks
Apartments during the UTSA Head Start Summer Institute.
________________________and ________________________ understand and agree that the applicant
Applicant’s Name
Supervisor’s Name
will adhere to the terms required for participation in the UTSA Head Start Summer Institute and that daily
class attendance is mandatory for the three-week summer sessions.
I verify that ________________________ is currently employed at ____________________________
Applicant's Name
Name of Head Start Center
as a _____________________________________________.
Applicant's Title/Position
_____________________________________
Head Start Center Supervisor’s Signature
_____________________________________
Head Start Program Director’s Signature
_____________________________________
Applicant’s Signature
____________________________
Date
____________________________
Date
____________________________
Date