Chamberlain Scholarship Application

Name *

Phone *

Email *

AFP Membership # *

Job Title *

Organization *

Organization's Charitable Registration #: *

Organization's Address *

Street Address

Address Line 2

City

Province

Postal Code

What percentage of your time do you spend on fundraising activities (minimum 20%)? *

Please briefly describe the fundraising-related responsibilities within your current role. *

How many years of experience do you have as a professional fundraiser? *

What are your personal career objectives? *

What is your plan for accomplishing your personal career objectives? *

Describe any volunteer activities you have been involved in over the last 2 years: *

List the fundraising conferences or workshops you've attended in the last 2 years and indicate whether your organization funded your participation. *

Why do you want to attend the AFP Icon international conference? What body of knowledge do you hope to gain by attending? *

Does your organization have a budget for professional development to support your participation in conferences and workshops? *

Yes

If yes, please indicate the total budget amount available and whether any of this funding is available to support your attendance.

Briefly describe in your own words the value and impact of your organization's charitable mission. *

I attest that the following criteria are true: *

I am a member in good standing of AFP Golden Horseshoe

I have at least 5 years of full-time experience as a professional fundraiser

I am currently employed as a fundraiser, consultant or non-profit staff members that spends a minimum of 20% of my time fundraising

I have not attended the AFP Icon international conference before

If I am selected as a bursary recipient, I agree to the following: *

I will attend the entire conference

I will submit a brief report at the conclusion of the conference

I will submit my proof of conference registration at the end of the conference for reimbursement

I agree to serve on an AFP Golden Horseshoe Committee or Board for a minimum of a one year term should an opportunity become available

Signature

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