First Name (Provide the name you would like on your name tent/name tag) *

Last Name *

Pronouns *
He/Him
She/Her
They/Them
Not listed Please specify a value for Pronouns

Email *
Please enter a GVSU faculty or staff email address ending in @gvsu.edu.

Employee Group *
- Select Option Administrative Professional (AP) Department of Public Safety (DPS; Police & Security Staff) Faculty Maintenance, Grounds and Service (MGS) Professional Support Staff (PSS)

Department *

What is your race and/or ethnicity?
Select all that apply.
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White

Do you have any direct reports? *
Yes
No

If you answered "yes" to having direct reports, please specify their classification. *
Hourly Staff
Salaried Staff
Faculty
Students
Not listed Please specify a value for If you answered "yes" to having direct reports, please specify their classification.

To be eligible to participate, you must be available in-person for the 2 full-day interactive session dates outlined below. Please select ‘Yes’ or ‘No’ depending on your availability.

Meeting location is on the Valley Campus, Kirkhof Center, RM 2266.

• Thursday October 22, 2026, 9:00 a.m.-4:00 p.m. 
• Thursday October 29, 2026, 9:00 a.m.-4:00 p.m. 

It is recommended you hold these dates and times on your calendar to ensure you remain available until you receive notification of your selection status.

Are you available in-person for the 2 dates indicated above? *
Yes
No

I have vetted the program dates for participation with my supervisor and obtained their full support to participate and prioritize my availability for the program. Note: Participants should not submit their interest form until they have done this step. *
Yes
No

Provide your supervisor's name and email for necessary program follow up. *

I have completed the CliftonStrengths assessment. (Please complete the assessment before submitting your interest form, since the results will be used during this program.) *
Yes
No