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Scholarship Application Form

All fields are required.

Please complete one application per request.

Contact Information

Attendee's name:

Attendee's title:

Organization name:

Street Address:

City:

State:

Zip:

Phone Number:

Fax Number:

E-mail address:

Organization Web Site Address:

Organization EIN (tax ID number):

Executive Director or Board Chair's name and title:

Organization Information

Total Organization Budget:

Mission:

Brief description of programs/target audience:

Choose the course your organization is interested in taking. View course titles, dates, and full descriptions on our web site.

Course title and date: First Choice

Course title and date: Second Choice

Describe the fundraising responsibilities of the person who will be attending from your organization:

Describe the expected outcomes course attendance will have on the development work of the organization:

Organizations selected will be expected to submit the following documents upon request:

One copy of organization's most recent annual operating budget
501(c)(3) designation letter from the IRS
List of board members