360° Leadership Analytics Assessment for Chairs

Request Form

Please complete the form below listing each chair you would like to request an analysis for. Please note that if you would like to administer these assessments for more than one chair and would like to conduct the assessments during different time periods you will need to fill out a separate request for each chair.

If you have any questions about the 360° Leadership Analytics Assessment for Chairs, please visit our support site.

Step 1 - Administration Dates

Chair Self-Assessment

This is the timeframe in which each chair will have to fill out their self-assessment.

Required! Start date cannot be later than end date
Required! End date cannot be earlier than start date
days

Rater Assessment

This is the timeframe in which each rater will have to fill out the assessment. The rater assessment can be administered at the same time as the Chair Self-Assessment.

Required! Start date cannot be later than end date
Required! End date cannot be earlier than start date
days

Step 2 - Primary Contact

Primary Contact Information

This is the person who will address general questions and make needed decisions during the process. The primary contact must also verify below that the survey process is being conducted as part of the formal/required institutional process or that the chair being rated has consented to the process.

Required!
First name required! Last name required!
Required!
Required!
Required! Invalid phone number Invalid extension
Required! Invalid email!

Step 3 - Billing Contact

Billing Contact Information

Please enter the billing address and the name of the person responsible for billing.

Required!
Required!
Required!
Required!
Required!
Required! Invalid zip code
Required! Invalid phone number Invalid extension
Required! Invalid email!

Step 4 - Department Chairs Being Assessed

Place your mouse cursor over any of the table headers to see additional help text.

Department Chair's Name Job title and unit Email Rater Emails Additional Questions Remove
Full name required! Required! Required! Invalid email!

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Step 5 - Review and Submit

When you hit the Submit button below, your request will be delivered to Campus Labs and you will be taken to a screen where you can review a summary of your request. A confirmation will be emailed to the primary contact listed on the request form. If there are any questions or concerns, Campus Labs Staff will follow-up with the primary contact.