Adobe Certified Instructor (ACI) Questionnaire for LiveCycle 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? ___ LiveCycle ES4: Developing a LiveCycle Application ___ LiveCycle ES4: LiveCycle Rights Management introduction ___ LiveCycle ES4: LiveCycle Designer Specialist workshop ___ LiveCycle ES4: LiveCycle Form Services Specialist workshop ___ LiveCycle ES4: LiveCycle Document Output Specialist workshop ___ LiveCycle ES4: LiveCycle Process Management Specialist workshop ___ LiveCycle ES4: LiveCycle PDF Generator Specialist Workshop ___ Other: Instructor Profile In order to qualify to teach LiveCycle courses, you will be evaluated on the following skill sets: LiveCycle Experience: All candidates must have development experience using LiveCycle. You will be required to present and describe applications you have completed, or deliver an application 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: R20130822 1 Gender: Title: Address: City: State/Province: Country: Zip/Postal Code: Work Phone: Home Phone: Email: Cell Phone: Website URL: Male Female Reference Information Provide 1 to 3 technical references (with contact information) that can verify and describe the LiveCycle or other technical 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 LiveCycle ES Experience Please list all LiveCycle related training you have attended. Course Location Instructor List which LiveCycle modules you have used, and how long you have used them: Please describe the applications you have worked on and the role you played during development. Related Technologies Experience 1. Rate yourself on a scale of 1-10 on the following areas: Java JavaScript Eclipse IDE XML/XPath 2. Explain how you have used the above in your work. When have you actively worked with Java, JavaScript, Eclipse IDE (or another Java IDE) and CML/XPath? 3. Describe your experience with relational databases; include when you did the work and how often you use this experience. 4. Describe your Web and other development experience related to LiveCycle ES URLs of websites, and the role in designing: Describe development of other technologies (Flex, ColdFusion, ASP, Java, etc.) Non-Web development projects / tools experience: R20130822 3