GPA-NCA Speaker/Facilitator Interest Form

Thank you for your interest in speaking to and facilitating conversations with your fellow GPA-NCA members! Please complete this brief form, and we will be in touch. If you have any questions, please contact program chair Tara Cox at coxt@nwf.org.

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* 1. What is your name and email?

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* 2. Would you like to present a session, facilitate a discussion, or both?

Present a Session

Facilitate a Discussion

Both

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* 3. What are your presentation topics of expertise? Or, if you would like to lead a discussion, what topics interest you? (For example: prospect research, proposal development, evaluation, foundation relations, etc.)

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* 4. I identify my gender as:

Female

Male

Transgender/Unspecified non-conforming

Prefer not to answer

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* 5. I identify my ethnicity as:

Asian/Asian American

Black/African American

Hispanic/Latino/Latina

Native American/American Indian/Alaska Native/Native Hawaiian

Multi-racial or multi-ethnic (2+ races/ethnicities)

Prefer Not to Answer