2027 Community Health Center University (CHCU) Application

Community Health Center University (CHCU) Leadership Program Application
Developing the next generation of Virginia's health center leaders.

Application deadline: October 15, 2026. Applicants will be selected by November 6, 2026.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name of Health Center
Health Center Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position/Title
Length of Service in Current Position (Years, Months)
Supervisor Name/Title
Supervisor Email
example@example.com
Supervisor Phone
Please enter a valid phone number.Format: (000) 000-0000.
Which of the following best describes your employer? (Select one)
Emergency Contact Name and Relationship
Would you require overnight accommodation for in-person sessions at the University of Richmond?
RESUME & REFERENCES: Upload a current copy of your professional resume and provide three (3) references that can speak to your current or potential leadership skills (ex: current/former supervisor, colleague, former teacher, friend).

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Please upload a letter of support from your current supervisor, signed by them and your CEO.

All letters should contain the following:
- I understand that all sessions of the program must be attended in person and will accommodate the applicant’s work schedule (initial of supervisor)
- I understand that the applicant MUST complete 10 sessions of leadership coaching (initial of supervisor)
Upload letter:

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Have you held a leadership role before within your organization? If yes, provide the length of time and describe your role and responsibilities. If no, describe what role you would like to have in leadership and why. (Limit 500 words)
Please describe your leadership style. If you are unsure, describe the type of leader you want to be. (Limit 500 words)
As an emerging leader, how do you address equity and inclusion within your current position? (Limit 500 words)
How do you see yourself working toward health equity in your current role? And if you move into a leadership role, how does this work change, if at all? (Limit 500 words)
What skills are you looking to gain by participating in this leadership course? (Limit 500 words)
Why should you be selected to participate in this leadership program? (Limit 500 words)
What would you say is the biggest leadership challenge within your organization? How can you help to meet that challenge? (Limit 500 words)
Please describe two opportunities for growth that this leadership program can help you to improve. (Limit 500 words)
What contributions have you made to your organization in your current position? (Limit 300 words)
List contributions you have made towards improving the operations, culture, and/or employee engagement within your current position. (Limit 300 words)
Describe one significant professional accomplishment you have made in the past three (3) years and what skills you used to meet the challenge. (Limit 500 words)
By submitting this application I acknowledge the TIME COMMITMENT and effort that it will take to complete this program:
Please type your full name as an electronic signature
Should be Empty:

Community Health Center University (CHCU) Leadership Program Application

Developing the next generation of Virginia's health center leaders.