Scholarship ApplicationFranklin Forum - May3, 2012
Email ONE word document to by
Monday, April 16, 2012 at 5:00 PM.
PLEASE NOTE:All Scholarships are partial. Consultants and volunteers are encouraged to attend the event, but are not eligible for scholarship support. You may NOT mail or fax your application; you MUST email it as ONE word document. You will get a reply email as a confirmation of receipt.
Name:
E-mail:
Job Title:
Phone:
Organization Name - must be a 501(c)(3):
Address:
City:
State:
Zip:
1. On average, how many hours per week do you spend on fundraising?
2. How long have you been doing fund raising for this organization?
3. In what year did your organization become a 501(c)(3) non-profit?
4. Are you a current member of the Greater Philadelphia Chapter of AFP?
(membership in AFP-GPC is not required in order to be eligible to receive a scholarship)
5. Have you ever received an AFP scholarship?
Year?
For which program/course did you receive a scholarship?
6. What skill do you hope to gain by participating at this educational session?
7. What fund-raising workshops have you attended in the past year or two?
8. Why is a scholarship important at this time?
9. Experience: List your previous non-profit positions (or include a copy of your resume as part of this word document):
10. Additional Comments:
Deadline for the Scholarship Application is: 5:00 PM, Monday, April 16, 2012
Email To:
11. How did you learn about AFP? Check One.
A Colleague
A local chapter activity or publication
An AFP Publication
The International Conference on Fundraising
A non-APF workshop
An advertisement in another organization’sPublication
AFP website
Previous AFP member
Non of the Above
12. Year of entry into fundraising?
13. Please complete the following information from your last completed fiscal year.
(Estimate to the nearest thousand)
a. Operating Budget of institution
$
(If you organization is the fundraising affiliate or foundation, please provide information for the primary institution.)
b. Expense budget of fundraising function
$
(Foundation, development department, etc.)
c. Philanthropic Dollars raised
$
14. In what type of organization are you currently employed? Check one.
Health Public/Society Benefit
Religious Consultant
Educational Not Currently Employed
Arts/Cultural/Humanities Retired
Human Services Other
15. In what year did you begin employment with your current organization?
16. With how many organizations have you been affiliated as a fundraising professional?
17. How many fundraisers are employed with your organization?
18. How many are associated with AFP?
The following information is not required, but your answers will assist us in serving you more effectively.
Gender: Female Male
Are you fluent in any languages other than English? Yes No
If yes, what languages?
Ethnic Background: Check One.
African American, not of Hispanic Origin
Alaskan Native
Native American
Asian/Pacific Islander
Caucasian, not of Hispanic Origin
Hispanic/Latino
Multi-Ethnic
Other
Deadline for the Scholarship Application is: 5:00 PM, Monday, April 16, 2012
Email To:
I certify that all of the information contained in this application is truthful. I understand that scholarships are limited. Therefore, should I receive an AFP Scholarship; I will attend that event unless I have given 48-hour notice of my cancellation. If I do not attend the event or cancel my registration according to the AFP-GPC cancellation policy, I understand that I/or my employer, will be responsible for the full fee. I understand that this scholarship is not transferable to another person.
Signed: ______Date: ______
(please type in your name)
Who introduced you to AFP? ______
ASSOCIATION OF FUNDRAISING PROFESSIONALS
Greater Philadelphia Chapter
100 North 20th Street, Suite 400 Philadelphia, PA 19103
Phone (215)
Deadline for the Scholarship Application is: 5:00 PM, Monday, April 16, 2012
Email To: