Empowerment Request Form

Your Name:

Your Email Address:

Your Immediate Manager's Name:

Your Immediate Manager's Email Address:

Your Area Manager's Name:

Your Area Manager's Email Address:

Your Job Title:

Area in which you request empowerment:

What date do you need empowerment?

How long? (If more than 24 hours, explain.)

Have you ever been empowered before? Yes No

Within the last six months? (If Yes, explain) Yes No

If you are empowered, do you agree to abide by the rules established by the corporate committee on empowerment?

(If No, stop now.) Yes No

Justification:

Please justify, in detail, your request for empowerment. Include such information as: Why you feel you deserve empowerment (i.e., why we would empower someone like you.); Why you think you could do your current job better if you were empowered; Just what it is that you would like us to consider empowering you to do; and why you don't just leave it to us who already have the power, instead of generating a lot of paperwork seeking to have some power doled out to you, as if we would seriously consider it anyway.

Your request will be reviewed by the Site Empowerment Coordinator (SEC), your management chain (up to and including the division president), and several co-op students from a local high school. You will be informed of their decision of your empowerment within 90 working days.

Form AZ99-0 (11/77)

 

 

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