AFP Foundation - 2017 Chamberlain Scholarship Program

Application Deadline: October 21, 2016

Applications must be submitted to Jeanne Warlick @ [email protected] or faxed to her attention at 626.355.0485.

For more information, contact Jeanne Warlick at [email protected] . or Amanda Green at [email protected].

Eligibility Requirements:

1. Candidate is employed as a fundraising professional or, if candidate is an executive director, a substantial amount of time must be devoted to fundraising. 2. Candidate has never attended an AFP or NSFRE International Conference on Fundraising as a registered participant (unless as a member of the Conference Host Committee). 3. Candidate must agree to complete an online evaluation form about his or her experience at International Conference. 4. Only one individual from any local organization or institution may be selected.

Personal Data

Applicant’s Name Are you a member of AFP? How long have you been a member of AFP? ______Job Title Employer Business Address City State Zip Business Phone Number Home Phone Number Email Address Website URL Supervisor’s Name (Printed) ______

Supervisor’s Signature ______(or signature of an Executive Committee member on your organization’s board)

Phone Number

of 3 Background Information Years in the Profession Previous Training in Fundraising (Please specify courses, seminars, conferences attended)

Professional Reference (Other than present employer)

Phone Email

Would you be able to attend this year’s conference without a scholarship? Y__ N__ If you answered yes, please provide a brief explanation here:

Why should you win this scholarship and how will you benefit?

Would you be willing to share information about your experience at the conference with fellow AFP GLAC members at a chapter meeting? Y__ N__

Are you willing to commit to completing a post-conference online evaluation? Y__ N__

I am employed as a full-time fundraising professional or spend at least fifty percent of my time fundraising for my employer. I have never attended an NSFRE/AFP International Conference on Fundraising and understand that only one individual from my local organization can be selected.

______Page 2 of 3 (Applicant’s Signature) (Date)