Choose your class

	Foundation Fundraising Essentials - San Francisco, CA 5/17/2013 ($295.00)
	Proposal Writing Workshop - San Francisco, CA 6/25/2013 ($295.00)

I. Contact Information

Name:

Your Title:

Organization Name:

Organization's Street Address:

City:

State:
  Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesa Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Outside U.S.

Zip Code:

Contact Telephone:

E-mail:

Organization web site:
http://

What is your organization's Employer Identification Number (EIN)?

Total Organization Budget:

Name and title of executive director or board chair supporting this request:

Name:

Title:

II. Organization Information

List some of the core programs or services your organization offers:

How many full- and part-time staff are currently employed by your organization?

Full: Part:

List your organization's current board members

III. Need For Scholarship

Name and title (or relationship to the organization) of the individual who will attend the course:

Name:

Title:

What prior experience does the individual have in development work?

What professional growth is desired as a result of attending the course?

How will the organization benefit from this individual receiving a scholarship?

What fundraising challenges does the individual or organization face? Describe, if any, challenges the organization encountered in raising funds from foundations.

Has the individual attended Foundation Center training programs or used the Center's library previously?
Yes No

If so, please list classes attended or resources used.

Attachments

IV. E-mail your organization's most recent annual revenue and expense budget

V. E-mail your 501(c)(3) designation letter from the IRS

The Scholarship Sub-Committee of the Advisory Board of the Foundation Center-San Francisco retains the right to determine the applicant's need based solely on this application.