Basics

Please tell us a little bit about yourself

First Name

Last Name 

Preferred Contact Email Address

Your Webex Teams Email

CCO User ID

Cisco Community ID

Street Address 

City

State or Province

Country

Zip Code/Postal Code

Birthday (Month & Day only)

Please answer question Who are you? (First Name) before continuing.

Please answer question Who are you? (Last Name) before continuing.

Please answer question Who are you? (Preferred Contact Email Address) before continuing.

Please answer question Who are you? (Street Address) before continuing.

Please answer question Who are you? (City) before continuing.

Please answer question Who are you? (Country) before continuing.

Please answer question Who are you? (Zip Code/Postal Code) before continuing.

Please answer question Who are you? (Birthday (Month & Day only)) before continuing.

Please share how we can get to know you online (URLs please) - I'm too lazy to look you up.

Twitter

LinkedIn

Blog

YouTube

Podcast

Other

Company / Organization Information

Where do you work?

What is your job title?

How long have you been in this role?

What is your company's website?

Please answer question What do you do? (Where do you work?) before continuing.

Please answer question What do you do? (What is your job title?) before continuing.

Please answer question What do you do? (How long have you been in this role?) before continuing.

Job Level (Yes, we asked about your job title above, this is for quick categorization for the marketing overlords)

1. CXO (i.e. CIO, CTO, CEO..)
2. VP / SVP
3. Director / Sr. Director
4. Manager / Sr. Manager
5. Architect
6. Network Engineer
7. Other?Please specify

What is your company's or organization's relationship to Cisco?

1. Analyst
2. Certification Training
3. Consultant
4. Customer
5. Partner (Sales / resale / VAR etc.)
6. Integrator
7. Technology Partner
8. Service Provider
9. OtherPlease specify

Please answer question What is your company's or organization's relationship to Cisco?3 before continuing.

How many employees are at your company / organization?

1. 0 – 249
2. 250 – 499
3. 500 – 999
4. 1000 – 1499
5. 1500 – 4999
6. 5000 – 9999
7. 10000+

Please answer question How many employees? before continuing.

Your Role

What is your primary area of focus?

1. Collaboration
2. Data Center
3. Internet of Things
4. Mobility / Wireless
5. Networking
6. Security
7. Service Provider

Please answer question What is your primary area of focus?5 before continuing.

What other interests do you have?

1. Business
2. Cloud
3. Collaboration
4. Data Center
5. Developer
6. Internet of Things
7. Mobility / Wireless
8. Networking
9. Programmability
10. Security
11. Service Provider
12. Small Business
13. Other? Do tell!Please specify

Cisco Designed for Small Business: Are you at a small business or work with small businesses?  Would you be interested in a pilot program within the Cisco Champions program?  

1. Yes!
2. No.
3. I have other thoughtsPlease specify

Tell us about your career so far. (Please don't just paste in your LinkedIn info. We want to *know* you.)

Please answer question Tell us about your career so far! before continuing.

Programs & Certifications

Do you belong to any other programs at Cisco?

1. Customer Connection Program
2. Cisco Learning Network
3. DevNet
4. Gateway
5. Webex Ambassadors
6. OthersPlease specify
7. No

Do you belong to any other programs with other companies? Other professional associations you're involved with? (Such as Microsoft MVP, vExperts, Veeam Vanguard, NetApp United, etc.)

Do you have any of the following Cisco certifications?

1. CCNA
2. DevNet Associate
3. CyberOps Associate
4. CCNP Enterprise
5. CyberOps Professional
6. CCNP Collaboration
7. CCNP Data Center
8. CCNP Security
9. CCNP Service Provider
10. DevNet Professional
11. CCDE
12. CCIE Enterprise Infrastructure
13. CCIE Enterprise Wireless
14. CCIE Collaboration
15. CCIE Data Center
16. CCIE Security
17. CCIE Service Provider
18. CCAr
19. Other?Please specify

Do you have any other certifications? If so, which ones? (Feel free to list any from Cisco we missed above and/or those from other companies.)

Champion Experiences

Are you a current or former Cisco Champion?   (Pick all years you have been in the program)

1. 2014
2. 2015
3. 2016
4. 2017
5. 2018
6. 2019
7. 2020
8. No, I'm new!

Please answer question 7 before continuing.

Please select at least 1 choices for question 7.

What are the top five activities you'd like to participate in as a Cisco Champion?
(Note: We don't expect a lot out of Champions, we know you have jobs and families and lives, but we do expect about an hour a week of engagement)

1. Attend pre-briefings
2. Beta / EFT testing
3. Co-host Cisco Champion Radio podcasts
4. Expand your blog / vlog / podcast
5. Join Coffee Hours
6. Give feedback on messaging
7. Give feedback on technology
8. Lead a Blogging Club Topic
9. Participate in Champions Webex Teams rooms
10. Share opinions on solutions
11. Speak at a Cisco Live
12. Other?Please specify

What makes you an Influencer?

Why do you want to be part of the Cisco Champion program?

Please answer question Why do you want to be a CC? before continuing.

How do you feel you can contribute and add value to the Cisco Champions program as a member? 

Please answer question How have you contributed? before continuing.

What have you liked about the Cisco Champion program so far? (Yes! This question just changed like *magic* for former / current Champs. Go you!)

Please answer question What do you like about the Cisco Champion program so far? before continuing.

How do you feel you've contributed to the Cisco Champions program?  How else would you like to contribute? (Wow! This question also just changed like *magic* for former / current Champs.)

Please answer question How have you contributed? before continuing.

Tell us something interesting about you.

If you could tell Chuck Robbins something, what would you tell him?

Nominate a Friend: Do you know someone who should totally be a Cisco Champion?  (PS: If you list an email address we will cc you in outreach. They will *not* be added to any weird mailers.)

Anything else you'd like to share?