Application for Contract Faculty Position

* - Indicates required fields   GENERAL INFORMATION * Title Mr. Mrs. Ms. Dr.   * First Name    MI    * Last Name         Suffix (i.e. Jr, MD, PhD)   * Email   Company   Job Title   * Address   * City * State (Select from list) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   * Zip Country   * Business Phone (Direct Line)    Business Phone (General) Mobile Phone Home Phone   * How did you find out about AMA Faculty? AMA Employee Referral * AMA Faculty Member Referral * Other Personal Referral * AMA Website ASTD IMC ODN PMI SHRM Other *     * If Other, please specify * If AMA or Other Personal Referral, please specify the name Please provide a link to a training demonstration video / or a link to your website.   * Attach your chronological Resume or CV EXPERTISE INFORMATION * Subject Matter Expertise (Primary)   Subject Matter Expertise (Secondary) * Industries Worked In    Press "Ctrl" key to select more than one value. Aerospace Communications Distribution Energy Financial Services Food Government - Federal Government - State Insurance Manufacturing Manufacturing - Consumer Goods Medical - Health-care(non-drug companies) Medical - Pharma (drug companies) Non-Profit/Membership/Association Publishing Retail Security Transportation Other   For industries with sub-speciality, please specify Audience Levels Press "Ctrl" key to select more than one value. President/CEO Senior Management Middle Management First Line Manager Administrative Support Tech/Professional List of clients in the last 18 months Note: Please separate each client using the ENTER key. EDUCATION Institution Degree Year Books/Articles Published Note: Please separate each book/article published using the ENTER key. For books, please include copyright date. For articles, include month, date, and year. Instructional Design Experience Press "Ctrl" key to select more than one value. Developed Assessment Tools Case Studies Programmed Instruction Leader's Guides Participant Notebooks Developing Content for E Delivery Adult and Accelerated Learning Theory Relevant O.D. Experience Press "Ctrl" key to select more than one value. 4 Levels of Evaluation Needs Analysis Exec/Topical Coaching LANGUAGE SKILLS Training Press "Ctrl" key to select more than one value. English French Italian Japanese Polish Russian Spanish Dutch German Mandarin Cantonese Other, please specify    Translation Press "Ctrl" key to select more than one value. English French Italian Japanese Polish Russian Spanish Dutch German Chinese Other, please specify Have you had experience delivering third party material? Please explain. Coaching and Other Professional Certifications (i.e. MBTI, AFC, PMP) Note: Please separate each coaching certification using the ENTER key. Experience with Instructional Instruments Press "Ctrl" key to select more than one value. DISC FIRO-B ISE LSI MBTI Mindex Neurolinguistic Communication Profile Platinum Rule-Behavioral Profiles Survival Situation Simulations Thomas-Kilmann Conflict Mode   Other experience with instructional instruments not listed, please specify Online Facilitation Experience Press "Ctrl" key to select more than one value. Webcast Online Course Instruction Online Mentoring/Coaching Other   Other facilitation experience not listed, please specify Please describe your on-line facilitation experience and/or e-coaching experience including platforms with which you are familiar with. Describe your keynote speaker experience including topics and audience. Which AMA seminars are you most interested in delivering for AMA? List specific titles if possible. What are your most relevant qualifications or experience in delivering these seminars? What are your goals and expectations for working with AMA? Please note that the recruitment and interviewing process of contract trainers includes a background check of your education, employment, and criminal history.