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: