-
8/12/2019 PMI Experience Hours
1/89
Project Name: Database Upgrade for Finance Department
See below for project description and contact information
1085 Total Hours for Project
40 Initiating
10 Conduct project selection methods to evaluate the feasibility
of new produ
5 Identify key stakeholders and perform analysis to gain buy-in
and requirem
10 Define the scope of the project based on the organization
need to meet th
5 Develop the project charter and review it with key
stakeholders to confirm
10 Identify and document high level risks, assumptions and
constraints using
200 Planning
40 Identify key project team members and define roles and
responsibilities to
30 Create the work breakdown structure with the team to develop
the cost, sc
40 Identify project risks to define risk strategies and develop
the risk manage30 Obtain project plan approval from the customer
and conduct a kick off me
40 Define and record detail project requirements, constraints
and assumption
20 Develop the change management plan to define how changes will
be hand
339 Executing
34 Manage proactively the resource allocation by ensuring that
appropriate re
34 Execute the tasks defined in the project plan in order to
achieve the projec
23 Ensure a common understanding and set expectations through
communic
35 Improve team performance by building team cohesiveness,
leading, ment
45 Implement a quality management plan to ensure that work is
being perfor
56 Implement approved changes according to the Change Management
Plan.
56 Obtain project resources in accordance with a procurement
plan.
56 Implement the approved actions and workarounds required to
minimize th
255 Monitoring and Controlling
56 Measure project performance using appropriate tools and
techniques.
56 Verify and manage changes to the project scope, project
schedule and pro
78 Monitor the status of all identified risks, identify any new
risks, take correcti
65 Ensure the project deliverables conform to quality standards
established in
251 Closing
34 Formalize and obtain final acceptance for the project.
34 Identify, document and communicate lessons learned.
54 Archive and retain project records, historical information
and documents (e
54 Obtain financial, legal and administrative project closure
(e.g. final paymen25 Release all project resources and provide
performance feedback.
25 Create and distribute final project report.
25 Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
2/89
Job Title
Project Coordinator
Organization (Company) Name
Finance R US
Organization (Company) Address12345 Finance R US Way
City State/Province
Moneyvale CA
Country Area/State/City Code
USA NA
Phone Number Extension
888-555-1212 NA
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
Finance R US
First Name Last Name
Irwin Scheister
Contact Relationship
Primary Stakeholder
Country Area/State/City Code
USA CA
Phone Number Extension
888-555-1313 NA
-
8/12/2019 PMI Experience Hours
3/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
4/89
Zip/Postal Code
90210
Country Code
NA
t this person to verify your work experience.
Country Code
NA
Project Start Date (MM/YY) Project Completion Date (MM/YY)
8/4/2005 9/15/2005
-
8/12/2019 PMI Experience Hours
5/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
6/89
-
8/12/2019 PMI Experience Hours
7/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
8/89
Project Name: Ericsson Prepaid Wireless System
See below for project description and contact information
1352 Total Hours for Project
124 Initiating
12 Conduct project selection methods to evaluate the feasibility
of new produ
30 Identify key stakeholders and perform analysis to gain buy-in
and requirem
54 Define the scope of the project based on the organization
need to meet th
8 Develop the project charter and review it with key
stakeholders to confirm
20 Identify and document high level risks, assumptions and
constraints using
200 Planning
20 Identify key project team members and define roles and
responsibilities to
110 Create the work breakdown structure with the team to develop
the cost, sc
20 Identify project risks to define risk strategies and develop
the risk manage20 Obtain project plan approval from the customer
and conduct a kick off me
10 Define and record detail project requirements, constraints
and assumption
20 Develop the change management plan to define how changes will
be hand
760 Executing
20 Manage proactively the resource allocation by ensuring that
appropriate re
460 Execute the tasks defined in the project plan in order to
achieve the projec
10 Ensure a common understanding and set expectations through
communic
70 Improve team performance by building team cohesiveness,
leading, ment
40 Implement a quality management plan to ensure that work is
being perfor
128 Implement approved changes according to the Change
Management Plan.
24 Obtain project resources in accordance with a procurement
plan.
8 Implement the approved actions and workarounds required to
minimize th
156 Monitoring and Controlling
16 Measure project performance using appropriate tools and
techniques.
60 Verify and manage changes to the project scope, project
schedule and pro
56 Monitor the status of all identified risks, identify any new
risks, take correcti
24 Ensure the project deliverables conform to quality standards
established in
112 Closing
8 Formalize and obtain final acceptance for the project.
24 Identify, document and communicate lessons learned.
36 Archive and retain project records, historical information
and documents (e
8 Obtain financial, legal and administrative project closure
(e.g. final paymen12 Release all project resources and provide
performance feedback.
16 Create and distribute final project report.
8 Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
9/89
Job Title
Solution Architect
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Gopal Ponangi
Contact Relationship
Country Area/State/City Code
Phone Number Extension
9725833089
-
8/12/2019 PMI Experience Hours
10/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
11/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
Apr-07 Feb-08
-
8/12/2019 PMI Experience Hours
12/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
13/89
-
8/12/2019 PMI Experience Hours
14/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
15/89
Project Name: Ericsson Sprint SDP (Service Delivery
Platform)
See below for project description and contact information
1794 Total Hours for Project
144 Initiating
16 Conduct project selection methods to evaluate the feasibility
of new produ
32 Identify key stakeholders and perform analysis to gain buy-in
and requirem
64 Define the scope of the project based on the organization
need to meet th
8 Develop the project charter and review it with key
stakeholders to confirm
24 Identify and document high level risks, assumptions and
constraints using
224 Planning
32 Identify key project team members and define roles and
responsibilities to
84 Create the work breakdown structure with the team to develop
the cost, sc
32 Identify project risks to define risk strategies and develop
the risk manage24 Obtain project plan approval from the customer
and conduct a kick off me
32 Define and record detail project requirements, constraints
and assumption
20 Develop the change management plan to define how changes will
be hand
1068 Executing
32 Manage proactively the resource allocation by ensuring that
appropriate re
596 Execute the tasks defined in the project plan in order to
achieve the projec
24 Ensure a common understanding and set expectations through
communic
96 Improve team performance by building team cohesiveness,
leading, ment
80 Implement a quality management plan to ensure that work is
being perfor
188 Implement approved changes according to the Change
Management Plan.
32 Obtain project resources in accordance with a procurement
plan.
20 Implement the approved actions and workarounds required to
minimize th
242 Monitoring and Controlling
24 Measure project performance using appropriate tools and
techniques.
96 Verify and manage changes to the project scope, project
schedule and pro
84 Monitor the status of all identified risks, identify any new
risks, take correcti
38 Ensure the project deliverables conform to quality standards
established in
116 Closing
8 Formalize and obtain final acceptance for the project.
32 Identify, document and communicate lessons learned.
24 Archive and retain project records, historical information
and documents (e
8 Obtain financial, legal and administrative project closure
(e.g. final paymen16 Release all project resources and provide
performance feedback.
12 Create and distribute final project report.
16 Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
16/89
Job Title
System Analyst
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Gopal Ponangi
Contact Relationship
Manager
Country Area/State/City Code
Phone Number Extension
9725833089
-
8/12/2019 PMI Experience Hours
17/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
18/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
Mar-08 Apr-09
-
8/12/2019 PMI Experience Hours
19/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
20/89
-
8/12/2019 PMI Experience Hours
21/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
22/89
Project Name: Ericsson ATT2G Answer Tones Platform
See below for project description and contact information
2192 Total Hours for Project
140 Initiating
12 Conduct project selection methods to evaluate the feasibility
of new produ
32 Identify key stakeholders and perform analysis to gain buy-in
and requirem
56 Define the scope of the project based on the organization
need to meet th
12 Develop the project charter and review it with key
stakeholders to confirm
28 Identify and document high level risks, assumptions and
constraints using
276 Planning
40 Identify key project team members and define roles and
responsibilities to
112 Create the work breakdown structure with the team to develop
the cost, sc
32 Identify project risks to define risk strategies and develop
the risk manage20 Obtain project plan approval from the customer
and conduct a kick off me
40 Define and record detail project requirements, constraints
and assumption
32 Develop the change management plan to define how changes will
be hand
1338 Executing
36 Manage proactively the resource allocation by ensuring that
appropriate re
856 Execute the tasks defined in the project plan in order to
achieve the projec
62 Ensure a common understanding and set expectations through
communic
44 Improve team performance by building team cohesiveness,
leading, ment
24 Implement a quality management plan to ensure that work is
being perfor
248 Implement approved changes according to the Change
Management Plan.
32 Obtain project resources in accordance with a procurement
plan.
36 Implement the approved actions and workarounds required to
minimize th
276 Monitoring and Controlling
32 Measure project performance using appropriate tools and
techniques.
108 Verify and manage changes to the project scope, project
schedule and pro
96 Monitor the status of all identified risks, identify any new
risks, take correcti
40 Ensure the project deliverables conform to quality standards
established in
162 Closing
12 Formalize and obtain final acceptance for the project.
32 Identify, document and communicate lessons learned.
48 Archive and retain project records, historical information
and documents (e
16 Obtain financial, legal and administrative project closure
(e.g. final paymen22 Release all project resources and provide
performance feedback.
16 Create and distribute final project report.
16 Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
23/89
Job Title
System Architect
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
William Ayers
Contact Relationship
Manager
Country Area/State/City Code
Phone Number Extension
9725832492
-
8/12/2019 PMI Experience Hours
24/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
25/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
May-09 Oct-10
-
8/12/2019 PMI Experience Hours
26/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
27/89
-
8/12/2019 PMI Experience Hours
28/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
29/89
Project Name:
See below for project description and contact information
0 Total Hours for Project
0 Initiating
Conduct project selection methods to evaluate the feasibility of
new produ
Identify key stakeholders and perform analysis to gain buy-in
and requirem
Define the scope of the project based on the organization need
to meet th
Develop the project charter and review it with key stakeholders
to confirm
Identify and document high level risks, assumptions and
constraints using
0 Planning
Identify key project team members and define roles and
responsibilities to
Create the work breakdown structure with the team to develop the
cost, sc
Identify project risks to define risk strategies and develop the
risk manageObtain project plan approval from the customer and
conduct a kick off me
Define and record detail project requirements, constraints and
assumption
Develop the change management plan to define how changes will be
hand
0 Executing
Manage proactively the resource allocation by ensuring that
appropriate re
Execute the tasks defined in the project plan in order to
achieve the projec
Ensure a common understanding and set expectations through
communic
Improve team performance by building team cohesiveness, leading,
ment
Implement a quality management plan to ensure that work is being
perfor
Implement approved changes according to the Change Management
Plan.
Obtain project resources in accordance with a procurement
plan.
Implement the approved actions and workarounds required to
minimize th
0 Monitoring and Controlling
Measure project performance using appropriate tools and
techniques.
Verify and manage changes to the project scope, project schedule
and pro
Monitor the status of all identified risks, identify any new
risks, take correcti
Ensure the project deliverables conform to quality standards
established in
0 Closing
Formalize and obtain final acceptance for the project.
Identify, document and communicate lessons learned.
Archive and retain project records, historical information and
documents (e
Obtain financial, legal and administrative project closure (e.g.
final paymenRelease all project resources and provide performance
feedback.
Create and distribute final project report.
Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
30/89
Job Title
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Contact Relationship
Country Area/State/City Code
Phone Number Extension
-
8/12/2019 PMI Experience Hours
31/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
32/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
-
8/12/2019 PMI Experience Hours
33/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
34/89
-
8/12/2019 PMI Experience Hours
35/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
36/89
Project Name:
See below for project description and contact information
0 Total Hours for Project
0 Initiating
Conduct project selection methods to evaluate the feasibility of
new produ
Identify key stakeholders and perform analysis to gain buy-in
and requirem
Define the scope of the project based on the organization need
to meet th
Develop the project charter and review it with key stakeholders
to confirm
Identify and document high level risks, assumptions and
constraints using
0 Planning
Identify key project team members and define roles and
responsibilities to
Create the work breakdown structure with the team to develop the
cost, sc
Identify project risks to define risk strategies and develop the
risk manageObtain project plan approval from the customer and
conduct a kick off me
Define and record detail project requirements, constraints and
assumption
Develop the change management plan to define how changes will be
hand
0 Executing
Manage proactively the resource allocation by ensuring that
appropriate re
Execute the tasks defined in the project plan in order to
achieve the projec
Ensure a common understanding and set expectations through
communic
Improve team performance by building team cohesiveness, leading,
ment
Implement a quality management plan to ensure that work is being
perfor
Implement approved changes according to the Change Management
Plan.
Obtain project resources in accordance with a procurement
plan.
Implement the approved actions and workarounds required to
minimize th
0 Monitoring and Controlling
Measure project performance using appropriate tools and
techniques.
Verify and manage changes to the project scope, project schedule
and pro
Monitor the status of all identified risks, identify any new
risks, take correcti
Ensure the project deliverables conform to quality standards
established in
0 Closing
Formalize and obtain final acceptance for the project.
Identify, document and communicate lessons learned.
Archive and retain project records, historical information and
documents (e
Obtain financial, legal and administrative project closure (e.g.
final paymenRelease all project resources and provide performance
feedback.
Create and distribute final project report.
Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
37/89
Job Title
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Contact Relationship
Country Area/State/City Code
Phone Number Extension
-
8/12/2019 PMI Experience Hours
38/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
39/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
-
8/12/2019 PMI Experience Hours
40/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
41/89
-
8/12/2019 PMI Experience Hours
42/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
43/89
Project Name:
See below for project description and contact information
0 Total Hours for Project
0 Initiating
Conduct project selection methods to evaluate the feasibility of
new produ
Identify key stakeholders and perform analysis to gain buy-in
and requirem
Define the scope of the project based on the organization need
to meet th
Develop the project charter and review it with key stakeholders
to confirm
Identify and document high level risks, assumptions and
constraints using
0 Planning
Identify key project team members and define roles and
responsibilities to
Create the work breakdown structure with the team to develop the
cost, sc
Identify project risks to define risk strategies and develop the
risk manageObtain project plan approval from the customer and
conduct a kick off me
Define and record detail project requirements, constraints and
assumption
Develop the change management plan to define how changes will be
hand
0 Executing
Manage proactively the resource allocation by ensuring that
appropriate re
Execute the tasks defined in the project plan in order to
achieve the projec
Ensure a common understanding and set expectations through
communic
Improve team performance by building team cohesiveness, leading,
ment
Implement a quality management plan to ensure that work is being
perfor
Implement approved changes according to the Change Management
Plan.
Obtain project resources in accordance with a procurement
plan.
Implement the approved actions and workarounds required to
minimize th
0 Monitoring and Controlling
Measure project performance using appropriate tools and
techniques.
Verify and manage changes to the project scope, project schedule
and pro
Monitor the status of all identified risks, identify any new
risks, take correcti
Ensure the project deliverables conform to quality standards
established in
0 Closing
Formalize and obtain final acceptance for the project.
Identify, document and communicate lessons learned.
Archive and retain project records, historical information and
documents (e
Obtain financial, legal and administrative project closure (e.g.
final paymenRelease all project resources and provide performance
feedback.
Create and distribute final project report.
Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
44/89
Job Title
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Contact Relationship
Country Area/State/City Code
Phone Number Extension
-
8/12/2019 PMI Experience Hours
45/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
46/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
-
8/12/2019 PMI Experience Hours
47/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
48/89
-
8/12/2019 PMI Experience Hours
49/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
50/89
Project Name:
See below for project description and contact information
0 Total Hours for Project
0 Initiating
Conduct project selection methods to evaluate the feasibility of
new produ
Identify key stakeholders and perform analysis to gain buy-in
and requirem
Define the scope of the project based on the organization need
to meet th
Develop the project charter and review it with key stakeholders
to confirm
Identify and document high level risks, assumptions and
constraints using
0 Planning
Identify key project team members and define roles and
responsibilities to
Create the work breakdown structure with the team to develop the
cost, sc
Identify project risks to define risk strategies and develop the
risk manageObtain project plan approval from the customer and
conduct a kick off me
Define and record detail project requirements, constraints and
assumption
Develop the change management plan to define how changes will be
hand
0 Executing
Manage proactively the resource allocation by ensuring that
appropriate re
Execute the tasks defined in the project plan in order to
achieve the projec
Ensure a common understanding and set expectations through
communic
Improve team performance by building team cohesiveness, leading,
ment
Implement a quality management plan to ensure that work is being
perfor
Implement approved changes according to the Change Management
Plan.
Obtain project resources in accordance with a procurement
plan.
Implement the approved actions and workarounds required to
minimize th
0 Monitoring and Controlling
Measure project performance using appropriate tools and
techniques.
Verify and manage changes to the project scope, project schedule
and pro
Monitor the status of all identified risks, identify any new
risks, take correcti
Ensure the project deliverables conform to quality standards
established in
0 Closing
Formalize and obtain final acceptance for the project.
Identify, document and communicate lessons learned.
Archive and retain project records, historical information and
documents (e
Obtain financial, legal and administrative project closure (e.g.
final paymenRelease all project resources and provide performance
feedback.
Create and distribute final project report.
Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
51/89
Job Title
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Contact Relationship
Country Area/State/City Code
Phone Number Extension
-
8/12/2019 PMI Experience Hours
52/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
53/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
-
8/12/2019 PMI Experience Hours
54/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
55/89
-
8/12/2019 PMI Experience Hours
56/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
57/89
Project Name:
See below for project description and contact information
0 Total Hours for Project
0 Initiating
Conduct project selection methods to evaluate the feasibility of
new produ
Identify key stakeholders and perform analysis to gain buy-in
and requirem
Define the scope of the project based on the organization need
to meet th
Develop the project charter and review it with key stakeholders
to confirm
Identify and document high level risks, assumptions and
constraints using
0 Planning
Identify key project team members and define roles and
responsibilities to
Create the work breakdown structure with the team to develop the
cost, sc
Identify project risks to define risk strategies and develop the
risk manageObtain project plan approval from the customer and
conduct a kick off me
Define and record detail project requirements, constraints and
assumption
Develop the change management plan to define how changes will be
hand
0 Executing
Manage proactively the resource allocation by ensuring that
appropriate re
Execute the tasks defined in the project plan in order to
achieve the projec
Ensure a common understanding and set expectations through
communic
Improve team performance by building team cohesiveness, leading,
ment
Implement a quality management plan to ensure that work is being
perfor
Implement approved changes according to the Change Management
Plan.
Obtain project resources in accordance with a procurement
plan.
Implement the approved actions and workarounds required to
minimize th
0 Monitoring and Controlling
Measure project performance using appropriate tools and
techniques.
Verify and manage changes to the project scope, project schedule
and pro
Monitor the status of all identified risks, identify any new
risks, take correcti
Ensure the project deliverables conform to quality standards
established in
0 Closing
Formalize and obtain final acceptance for the project.
Identify, document and communicate lessons learned.
Archive and retain project records, historical information and
documents (e
Obtain financial, legal and administrative project closure (e.g.
final paymenRelease all project resources and provide performance
feedback.
Create and distribute final project report.
Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
58/89
Job Title
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Contact Relationship
Country Area/State/City Code
Phone Number Extension
-
8/12/2019 PMI Experience Hours
59/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
60/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
-
8/12/2019 PMI Experience Hours
61/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
62/89
-
8/12/2019 PMI Experience Hours
63/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
64/89
Project Name:
See below for project description and contact information
0 Total Hours for Project
0 Initiating
Conduct project selection methods to evaluate the feasibility of
new produ
Identify key stakeholders and perform analysis to gain buy-in
and requirem
Define the scope of the project based on the organization need
to meet th
Develop the project charter and review it with key stakeholders
to confirm
Identify and document high level risks, assumptions and
constraints using
0 Planning
Identify key project team members and define roles and
responsibilities to
Create the work breakdown structure with the team to develop the
cost, sc
Identify project risks to define risk strategies and develop the
risk manageObtain project plan approval from the customer and
conduct a kick off me
Define and record detail project requirements, constraints and
assumption
Develop the change management plan to define how changes will be
hand
0 Executing
Manage proactively the resource allocation by ensuring that
appropriate re
Execute the tasks defined in the project plan in order to
achieve the projec
Ensure a common understanding and set expectations through
communic
Improve team performance by building team cohesiveness, leading,
ment
Implement a quality management plan to ensure that work is being
perfor
Implement approved changes according to the Change Management
Plan.
Obtain project resources in accordance with a procurement
plan.
Implement the approved actions and workarounds required to
minimize th
0 Monitoring and Controlling
Measure project performance using appropriate tools and
techniques.
Verify and manage changes to the project scope, project schedule
and pro
Monitor the status of all identified risks, identify any new
risks, take correcti
Ensure the project deliverables conform to quality standards
established in
0 Closing
Formalize and obtain final acceptance for the project.
Identify, document and communicate lessons learned.
Archive and retain project records, historical information and
documents (e
Obtain financial, legal and administrative project closure (e.g.
final paymenRelease all project resources and provide performance
feedback.
Create and distribute final project report.
Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
65/89
Job Title
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Contact Relationship
Country Area/State/City Code
Phone Number Extension
-
8/12/2019 PMI Experience Hours
66/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
67/89
Zip/Postal Code
Country Code
t this person to verify your work experience.
Country Code
Project Start Date (MM/YY) Project Completion Date (MM/YY)
-
8/12/2019 PMI Experience Hours
68/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
69/89
-
8/12/2019 PMI Experience Hours
70/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
71/89
Project Name:
See below for project description and contact information
0 Total Hours for Project
0 Initiating
Conduct project selection methods to evaluate the feasibility of
new produ
Identify key stakeholders and perform analysis to gain buy-in
and requirem
Define the scope of the project based on the organization need
to meet th
Develop the project charter and review it with key stakeholders
to confirm
Identify and document high level risks, assumptions and
constraints using
0 Planning
Identify key project team members and define roles and
responsibilities to
Create the work breakdown structure with the team to develop the
cost, sc
Identify project risks to define risk strategies and develop the
risk manageObtain project plan approval from the customer and
conduct a kick off me
Define and record detail project requirements, constraints and
assumption
Develop the change management plan to define how changes will be
hand
0 Executing
Manage proactively the resource allocation by ensuring that
appropriate re
Execute the tasks defined in the project plan in order to
achieve the projec
Ensure a common understanding and set expectations through
communic
Improve team performance by building team cohesiveness, leading,
ment
Implement a quality management plan to ensure that work is being
perfor
Implement approved changes according to the Change Management
Plan.
Obtain project resources in accordance with a procurement
plan.
Implement the approved actions and workarounds required to
minimize th
0 Monitoring and Controlling
Measure project performance using appropriate tools and
techniques.
Verify and manage changes to the project scope, project schedule
and pro
Monitor the status of all identified risks, identify any new
risks, take correcti
Ensure the project deliverables conform to quality standards
established in
0 Closing
Formalize and obtain final acceptance for the project.
Identify, document and communicate lessons learned.
Archive and retain project records, historical information and
documents (e
Obtain financial, legal and administrative project closure (e.g.
final paymenRelease all project resources and provide performance
feedback.
Create and distribute final project report.
Measure customer satisfaction at the end of the project.
Please identify the organization (company) for which you managed
t
-
8/12/2019 PMI Experience Hours
72/89
Job Title
Organization (Company) Name
Organization (Company) Address
City State/Province
Country Area/State/City Code
Phone Number Extension
Please identify your primary contact for this project. PMI may
contac
Organization (Company) Contact
First Name Last Name
Contact Relationship
Country Area/State/City Code
Phone Number Extension
-
8/12/2019 PMI Experience Hours
73/89
ts or services
ents for the success of the project
customer project expectations
roject scope, risks, issues, assumptions and constraints as well
as obtain project charter approval from
historical data and expert judgment
create a project organization structure to develop a
communication plan
hedule, resource, quality and procurement plans
ent planting with all key stakeholders
with the stakeholders to establish the project deliverables
led to manager the triple constraints
sources and tools are assigned to the tasks according to the
project plan.
goals.
tion to align the stakeholders and team members.
ring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost moral
ed according to required quality standards.
.
impact of project risks.
ject costs as defined in the change management plan.
ve actions and update the risks response plan.
the project quality plan.
.g. project schedule, project plan, lessons learned, surveys,
risk and issues logs, etc.) in order to retain
ts, warranties, contract signoff).
is project.
-
8/12/2019 PMI Experience Hours
74/89
-
8/12/2019 PMI Experience Hours
75/89
project sponsor
e.
organizational knowledge, comply with statutory requirements,
and ensure availability of data for potenti
-
8/12/2019 PMI Experience Hours
76/89
-
8/12/2019 PMI Experience Hours
77/89
al use in future projects and internal/external audits.
-
8/12/2019 PMI Experience Hours
78/89
Education Attained
Year diploma/degree was awarded Name of High School, College or
University
High School, College or University Address
City State/Province Zip/Postal Code
Country Country Code Area/State/City Code
Field of Study
Please document 35 contact hours of project management
education/training. These hours ma
A. Courses or programs offered by PMI Registered Education
Providers (R.E.P.)
B. University/college academic and continuing education
programs
C. Courses or programs offered by PMI Component
organizations
D. Courses or programs offered by employer/company-sponsored
programs
E. Courses or programs offered by distance-learning companies
ending with a tutorial segment
F. Courses or programs offered by training companies or
consultants
The following education does not satisfy the education
requirements:
PMI Chapter meetings
Self-study (e.g. reading books)
1. Institution Name
Name of Course Attended
Course Start Date (MM/YY) Course Completion Date (MM/YY)
Contact Hours Earned Category (Please select A through F from
the listing abov
2. Institution Name
-
8/12/2019 PMI Experience Hours
79/89
Name of Course Attended
Course Start Date (MM/YY) Course Completion Date (MM/YY)
Contact Hours Earned Category (Please select A through F from
the listing abov
-
8/12/2019 PMI Experience Hours
80/89
include content on project, quality, scope, time, cost, human
resources, communication, risk,
e)
-
8/12/2019 PMI Experience Hours
81/89
e)
-
8/12/2019 PMI Experience Hours
82/89
-
8/12/2019 PMI Experience Hours
83/89
-
8/12/2019 PMI Experience Hours
84/89
ore of the following categories satisfy the education
requirement:
-
8/12/2019 PMI Experience Hours
85/89
Project 1 Project 2 Project 3 Project 4 Project 5 Project 6
Project 7 Project 8
1352 1794 2192 0 0 0 0 0
124 144 140 0 0 0 0 0
12 16 12 0 0 0 0 030 32 32 0 0 0 0 0
54 64 56 0 0 0 0 0
8 8 12 0 0 0 0 0
20 24 28 0 0 0 0 0
200 224 276 0 0 0 0 0
20 32 40 0 0 0 0 0
110 84 112 0 0 0 0 0
20 32 32 0 0 0 0 0
20 24 20 0 0 0 0 0
10 32 40 0 0 0 0 0
20 20 32 0 0 0 0 0
760 1068 1338 0 0 0 0 0
20 40 36 0 0 0 0 0
460 480 856 0 0 0 0 0
10 24 62 0 0 0 0 0
70 96 44 0 0 0 0 0
40 80 24 0 0 0 0 0
128 112 248 0 0 0 0 0
24 32 32 0 0 0 0 0
8 20 36 0 0 0 0 0
156 242 276 0 0 0 0 0
16 24 32 0 0 0 0 0
60 96 108 0 0 0 0 0
56 84 96 0 0 0 0 0
24 38 40 0 0 0 0 0
112 116 162 0 0 0 0 0
8 8 12 0 0 0 0 0
24 32 32 0 0 0 0 0
36 24 48 0 0 0 0 0
8 8 16 0 0 0 0 0
12 16 22 0 0 0 0 0
16 12 16 0 0 0 0 0
8 16 16 0 0 0 0 0
-
8/12/2019 PMI Experience Hours
86/89
-
8/12/2019 PMI Experience Hours
87/89
roducts or servicesuirements for the success of the project
et the customer project expectations
firm project scope, risks, issues, assumptions and constraints
as well as obtain project charter approva
sing historical data and expert judgment
es to create a project organization structure to develop a
communication plan
st, schedule, resource, quality and procurement plans
nagement plan
f meeting with all key stakeholders
ptions with the stakeholders to establish the project
deliverables
handled to manager the triple constraints
te resources and tools are assigned to the tasks according to
the project plan.
roject goals.
unication to align the stakeholders and team members.
mentoring, training, and motivating in order to facilitate
cooperation, ensure project efficiency and boost
erformed according to required quality standards.
Plan.
ze the impact of project risks.
.
d project costs as defined in the change management plan.
rrective actions and update the risks response plan.
ed in the project quality plan.
nts (e.g. project schedule, project plan, lessons learned,
surveys, risk and issues logs, etc.) in order to r
yments, warranties, contract signoff).
-
8/12/2019 PMI Experience Hours
88/89
l from project sponsor
morale.
etain organizational knowledge, comply with statutory
requirements, and ensure availability of data for p
-
8/12/2019 PMI Experience Hours
89/89
otential use in future projects and internal/external
audits.
