Adobe Certified Instructor (ACI) Questionnaire for Premiere Pro Program Notes/Instructions You must complete the appropriate exam(s) before applying for ACI status. Instructor candidates must complete all information requested on this questionnaire and return to Adobe using the following email address: dcrookst@adobe.com. Make sure to save a copy of the form for your records and for when you apply for other ACI status on different workshops. Please complete in full. Type of Candidate ___ Independent Instructor Candidate (Adobe Certified Instructor - ACI) ___ Partner Instructor Candidate (Adobe Authorized Training Center - AATC) ACI company name (for independent ACIs): AATC name (for partner instructors): Which course(s) are you interested in teaching? ___ Premiere Pro CC - Introduction to Premiere Pro (101) ___ Premiere Pro CC - Transitioning to Premiere Pro for Experienced Editors (250) ___ Other: Instructor Profile In order to qualify to teach Premiere Pro courses, you will be evaluated on the following skill sets: Premiere Pro Experience: All candidates must have video editing and finishing experience using Premiere Pro. You will be required to present and describe projects you have completed, or provide links to projects you have completed that can be reviewed. Training Experience: Instructor candidates should have completed one of the following to prove their training competence: - Previous instructor certification from another hardware or software vendor - Provide evidence of employment as an instructor for an academic institution or another company that provides training - Successful completion of an instructional skills seminar or class - Successful completion of a standup trainer assessment by an Adobe certified master instructor Candidate Information Company Name: Company Contact First Name: Last Name: Gender: Title: Address: City: State/Province: Country: R20130822 Male Female 1 Zip/Postal Code: Work Phone: Home Phone: Email: Cell Phone: Website URL: Reference Information Provide 1 to 3 technical references (with contact information) that can verify and describe the Premiere Pro or other video project(s) you have worked on. Contact Name Email Address Project Name Teaching Experience Enter the number of years/months you have been teaching technical subject matter: Train-the-Trainer skills course you have taken: (Program name, date, location) In the table below, describe the formal training classes that you have taught. Course Taught Length Date Range Location Describe any other technical training experience including when and for what time period (ex. mentoring): Describe any other instructor certifications you have received, naming the vendor and date certified: R20130822 2 Premiere Pro Experience Please list all Premiere Pro and other video editing related training you have attended. Course Location Instructor Please describe one or two projects you have worked on and the role you played as it relates to your video editing and finishing experience and specifically your Premiere Pro experience. List the video URLs and briefly explain your role in each. Related Technologies Experience 1. Rate yourself on a scale of 1-10 on the following products: Final Cut Avid 2. Explain how you have used the above in your work. R20130822 3 Other _________________