First Name

Last Name

Tittle / Organization

Professional Credentials

Chapter Affiliation

Member ID

Address

City

State

Zip

Phone Number

Email Address

Brief Bio of Presenter (50 words max)

Co-presenter(s) for this Workshop (include name, professional credentials, & contact information)

Track Selection Track SelectionAnnual GivingMajor Gifts & Prospect DevelopmentPlanned GivingCommunications & Social MediaSpecial Events & MarketingStewardship & Donor RelationCareer DevelopmentTrends in Philanthrop

Title of Workshop

Description of Workshop (50 words max)

Take Away from this Workshop

Target Participant Demographics for this Workshop

Number of full-time fundraising professionals Number of full-time fundraising professionals0-23-55+

Years of experience in development Years of experience in development<11-45+

Primary fundraising strategies (select up to three) Primary fundraising strategies (select up to three) Annual fund Events Corporate partnerships Foundation grants Major gifts Planned gifts Special campaigns

Teaching Methods for this Workshop

Description of Handouts for this Workshop

Names, titles and contact information for two (2) references who can attest to your professional expertise and presentation skills

Provide link to video of you presenting

Provide link to your LinkedIn profile

I am willing to lead an affinity breakfast roundtable I am willing to lead an affinity breakfast roundtable Yes No