Collegiate Certificate Application Form

Collegiate Certificate Application

When completing this application, please provide the activity date, a brief description of the activity and the points awarded for each activity. Each category should have a subtotal of earned points. Total points required equals 95, and total points will be automatically calculated from subcategories entries on the final page of this application.
Full Name*

First NameMiddle NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
Phone Number

Area CodePhone Number
Date Range of Eligible Activities (Certificate recipients must be active students at the time the certificate criteria are completed. Certificate criteria are designed to be achievable in one academic year, but applicants may take up to three years to complete the criteria if desired.)

EDUCATION: Ethics (5 point minimum) 20 points: 3 or 4 credit university course on ethics, 10 points: 1 or 2 credit university course on ethics, 5 points: per 50 minutes of AFP education program on ethics *

	Activity Date	Description	Points
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Education Ethics Summary Statement: Please describe what you learned regarding the vital role ethics plays in fundraising and non-profit management. *

EDUCATION: (20 point minimum) 20 points: 3 or 4 credit university course on fundraising or non-profit management, 10 points: 1 or 2 credit university course on fundraising or non-profit management, 5 points: per 50 minutes of AFP education program *

	Activity Date	Description	Points
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Education Summary Statement: What would you describe as the most important piece of knowledge you gained from these classes regarding the practice of fundraising? *
Total Education Points: (25 point minimum)*

PROFESSIONAL PRACTICE: (20 point minimum) 20 points: per term for a Fundraising related job or internship, 5 points: for a job shadowing session or informational interview, 5 points: for each chapter fundraising/philanthropic project event/meeting attended, 5 points: chapter specific option (please specify below if choosing this option) *

	Activity Date	Description	Points
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Professional Practice Summary Statement: What was the most challenging situation you encountered during an internship or activity and how did you meet that challenge? *
Total Professional Practice Points: (20 point minimum)*

CHAPTER INVOLVEMENT: (20 point minimum) 20 points: AFP Chapter Officer (one year term), 15 points: AFP Chapter Committee/Task Force Chair/Co-Chair (one year term), 5 points: AFP Chapter Committee member (one year term), 5 points: for working the AFP information table at a recruitment event, 2 points: per chapter business meeting (either collegiate or professional chapter), 5 points: chapter specific option (please specify below if choosing this option) *

	Activity Date	Description	Points
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Chapter Involvement Summary Statement: AFP Chapters are sustained on the commitment, involvement and leadership of their members. Describe what types of leadership experiences you observed or took part in. *
Total Chapter Involvement Points: (20 point minimum) *

VOLUNTEER SERVICE: (10 point minimum) 1 point: per hour of service - Volunteer/community service outside of AFP activities (includes direct service, board meetings, etc.) *

	Activity Date	Description	Points
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Volunteer Service Summary Statement: What was most rewarding about your volunteering experiences?*
Total Volunteer Service Points: (10 point minimum)*

Final Statement: Considering all of your AFP experiences thus far, what does philanthropy mean to you and why? How has your involvement in AFP strengthened or changed your perspective?*

Total Certificate Points*
We hereby certify that the statements contained herein accurately reflect the circumstances reported. Signature of the chapter member and either professional chapter or campus adviser required. Member Signature
Adviser Name
Adviser Signature
Should be Empty: