Department Chairs Certification Program Registration Form
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Your registration form will not be stored or saved automatically during your registration process and cannot be saved over multiple sessions. Your data will only be saved after submitting this form. Registrants are encouraged to complete the form in one session. (All fields are required unless otherwise noted.)

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Email *
Participation Requirements
Please note your attendance is required at all three session dates: Tuesday, July 14th, Wednesday, July 15th, and Thursday, July 16th. If you are unable to attend all three session dates, you will be unable to participate in the Summer 2020 Department Chairs Certification Program.
First Name   *
Last Name *
Title *
Department *
VCU Box Number *
Email *
Telephone *
Please note any dietary restrictions *
Background Information
What is your primary campus affiliation? *
How long have you been employed at Virginia Commonwealth University? *
How long have you been a department chair? *
How would you describe the size of your department? *
Self Evaluation
Please rate yourself, on a scale of 1 to 10, on each of the following items.
A rating of 1 is low,  5 can be considered average,  10 is high as possible
Knowledge of VCU’s mission, vision and strategic plan *
Knowledge of the structure of VCU and how it functions   *
Knowledge of your leadership strengths and weaknesses in current role *
Skill in leading in context of diversity *
Skills in “people” issues: managing conflict, building a team, coaching others   *
Clarity of your vision for your unit/area of responsibility *
Expertise in building a climate of inclusion *
Ability to “get results” in your work *
Overall confidence in your ability to lead effectively in your current role   *
Please respond to the following open-ended questions.
What do you consider to be your main strengths as a department chair? *
What knowledge and/or skills would you like to gain from the Department Chair Certification Program? *
What are the most important issues or challenges currently facing your department? *
Do you have any other comments?
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