Evaluator Form

CREDIT and Military Programs
American Council on Education
One Dupont Circle, NW
Suite 250
Washington, DC 20036-1193
202-939-9370 or 866-205-6267
evaluator@acenet.edu
INSTRUCTIONS: To be considered as a prospective evaluator, or to update your information currently on file at ACE, please complete and submit this form along with a current copy of your curriculum vitae/resume. Please provide as much information as possible; mandatory items are indicated by a red asterisk (note: some fields may appear yellow if the "autofill" option is enabled for your browser; such yellow highlighting is not an indication of a mandatory field).
FULL NAME*
Prefix
First Name/Initial*
Middle Name/Initial
Last Name*
Suffix
MAILING ADDRESS*
Street Address*
City*
State/Province*
Zip/Postal Code*
Country Code*
Email Address(es)*
(Please put your preferred "Pref" address for ACE-related communications in the first position.)
 Pref  Email Address(es)
Phone Number(s)*
(e.g. 256-555-1234. Please put your preferred "Pref" number for ACE-related communications in the first position.)
 Type  Pref  Number  Extension  
  Add New Row to Telephone Numbers
PRIMARY INSTITUTIONAL AFFILIATION*
Academic institution where you are currently teaching. Note that this institution must be recognized by CHEA.
Institution Name*
Institution Website*
City*
State*
Department
Job Title
Teaching Experience*
Please provide the following elements of information for all courses you are currently teaching or have taught in the past two years at this institution:
  • DD — Is the course distance-delivered (e.g., via internet or by correspondence)?
  • AcadLvl — At what academic level is the course taught?
    • voc = vocational certificate
    • low = lower-division baccalaureate/associate degree
    • up = upper-division baccalaureate degree
    • grad = graduate degree
  • Course Number — Prefix and number as reflected in your institution's course catalog.
  • Course Title — Title as reflected in your institution's course catalog.
DD AcadLvl   Course Number  Course Title  
Add New Row to Teaching Experience
Add Institutional Affiliation
EDUCATION*
Please provide the following elements of information for your educational background:
  • Credential — Choose from the drop-down menu:
    • Certification (e.g., PMP, CISSP, RN, etc.)
    • Associate (e.g., AA, AS, AAS, etc.)
    • Bachelor's (e.g., BA, BS, BBA, etc.)
    • Master's (e.g., MA, MS, MEd, etc.)
    • Doctorate (e.g., PhD, EDD, DBA, etc.)
  • Discipline/Name — List area of concentration for degrees; list name of certifications.
 Credential  Discipline/Name  
Add New Row to Education Credentials
MILITARY SERVICE
Are You a Veteran of the U.S. Military   Branch*  
Additional Data
(Highest rank held,
 years of service,
 any other applicable info)
BIOGRAPHICAL SKETCH*
Please provide a two-paragraph biographical sketch patterned after the following example. Biographies are used on official team lists and must fit the template below.
As Professor and Chair of the graduate program in the College of Engineering and Technology at the University of Virginia, Dr. Smith teaches in such areas as model and simulation, engineering, management, electronic circuits, linear systems, and several introductory engineering courses. Video-audio and computer-conferencing are routinely incorporated as part of these learning experiences.

Dr. Smith received her B.S. in Electrical Engineering from Old Dominion University and both her M.S. and Ph.D. in Industrial and Systems Engineering from the University of Wisconsin-Madison. She brings over 20 years of experience in teaching and learning at a distance, three national awards in distance education programming, and international experience on the use of distance education in engineering.
Paragraph One*
Paragraph Two*
CURRICULUM VITAE/RESUME
Please attach a current copy of your cv/resume, or separately email it to ACE Military Evaluations at evaluator@acenet.edu
Full pathname to resume (e.g., C:\Documents and Settings\Owner\MyDocuments\MyResume.doc):
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