Name Company Name Address Telephone Email Employed by a NADCA Member Company Yes No ASCS Certified Yes No CVI Certified Yes No List other industry certifications currently held Describe your educational preparation, including degree and institution Describe your experience in instruction and/or public speaking Describe your experience in the air duct cleaning business (e.g. include positions, years in position, special qualifications, and certifications) Identify which of the following courses you are applying to instruct: ASCS to the ACR Standard Training Course (ASCS certification required) CVI Training Course (CVI certification required) Describe your experience related to the class you wish to be considered Describe your familiarity with and use of industry standards including ACR, the NADCA Standard Tell us briefly why you want to become a NADCA instructor Do you have experience using PowerPoint? Yes No List language(s) spoken: Provide three Professional References Reference #1 Name Title Telephone Reference #2 Name Title Telephone Reference #3 Name Title Telephone Required Attachment: Resume Upload Upload requirementsOne file only.8 MB limit.Allowed types: pdf, doc, docx. Optional Attachments: Video clip demonstrating a presentation or public speaking engagement you have delivered. Please provide a Link to either a YouTube or Vimeo Video Testimonials from individuals you have trained and/or presented to. Upload Upload requirementsOne file only.8 MB limit.Allowed types: pdf, doc, docx. Submit
