Scholarship Application
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Diversity & Outreach
Full Day Seminar
Scholarship Application
Email to chapter@ by – June 1, 2012 at 5:00 PM.
PLEASE NOTE: All Diversity & Outreach Meeting-Event Scholarships are partial. You may NOT mail or fax your application; you must email it as ONE word document.
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 fundraising 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 meeting-event scholarship)
5. Have you ever received an AFP meeting-event scholarship?
Year?
For which program/course did you receive a scholarship?
6. What skill do you hope to gain by attending this educational session?
7. What fundraising meetings/events 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. Are you interested in serving on the AFP-GPC Diversity & Outreach Committee?
11. How did you learn about AFP-GPC?
Check One.
( A Colleague
( A local chapter activity or publication
( An AFP or AFP-GPC publication
( The International Conference on Fundraising
( A non-AFP workshop
( An advertisement in another organization’s publication
( AFP or AFP-GPC website
( Previous AFP member
( None 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
( LGBT
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?
Which of the following backgrounds do you associate with:
( African American, not of Hispanic Origin
( Alaskan Native
( Native American
( Asian/Pacific Islander
( Caucasian, not of Hispanic Origin
( Hispanic/Latino
( Multi-Ethnic
( Other
I certify that all of the information contained in this application is truthful. I understand that scholarships are limited. Should I receive an AFP meeting/event 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) 321-3871 Chapter@
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